Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Hospital Capacity Emergency Preparedness topic
No spam. Unsubscribe anytime.
Bill would require insurers to waive prior authorization during hospital capacity surge
Summary
Sen. William J. Driscoll Jr. filed legislation Jan. 17, 2025, that would require the Massachusetts Division of Insurance, in collaboration with the Department of Public Health, to direct health carriers to waive prior‑authorization requirements affecting patient transportation or discharge when inpatient staffed‑bed capacity reaches specified surge triggers.
Sen. William J. Driscoll Jr. filed legislation Jan. 17, 2025, that would require the Massachusetts Division of Insurance, in collaboration with the Department of Public Health, to direct health insurance carriers to waive prior-authorization requirements that affect the transportation or discharge of patients when hospital inpatient staffed‑bed capacity meets or exceeds 85% for 72 hours in a Health and Medical Coordinating Coalition (HMCC) region or when the Department of Public Health (DPH) activates its Capacity Planning and Response Guidance for Acute Care Hospitals.
The measure says waivers must last for not less than 30 days or, if triggered by DPH activation, for the duration of that activation. It also directs the Division of Insurance, in consultation with the DPH, to publish guidance implementing the provision within 30 days of the act’s passage.
If enacted, the bill would apply at the HMCC‑region level as defined by the DPH; the text does not make the requirement statewide unless the regional trigger is met or the DPH activates its statewide guidance. The filing cites specific operational triggers (85% staffed‑bed capacity sustained for 72 hours) and administrative steps (direction by the Division of Insurance and publication of guidance within 30 days).
The bill text notes a related filing in the prior legislative session (House No. 733 of 2023‑2024) but does not specify committee referrals, funding, or an implementation timetable beyond the guidance publication timeline. The proposal places operational responsibility on two state agencies: the Division of Insurance to direct carriers and the Department of Public Health to define the HMCC regions and to activate its Capacity Planning and Response Guidance when appropriate.
The filing does not include reported votes or formal legislative action beyond the petition; it is presented as Senate Docket No. 2472, Senate Bill No. 538. The bill does not specify penalties, enforcement mechanisms, or appropriations to implement the directive. It also does not list any quotes from legislative proponents or opponents in the filing itself.
Next steps under standard legislative process (not specified in the bill text) would typically include referral to a committee and public hearings; the bill text provided does not list those actions or a timeline.
