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Budget Summary FY2015

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Outside Section 172
Data Current as of:  10/17/2014

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Health insurance criteria and protocol availability II

SECTION 172.   The second paragraph of subsection (a) of section 12 of chapter 176O of the General Laws, as appearing in section 199 of chapter 224 of the acts of 2012, is hereby amended by striking out the third sentence and inserting in place thereof the following sentence:- Utilization review criteria shall be applied consistently by a carrier or a utilization review organization and made easily accessible and up-to-date on a carrier or utilization review organization's website and upon request to the general public; provided, however, that a carrier shall not be required to disclose licensed, proprietary criteria purchased by a carrier or utilization review organization on its website, but shall disclose such licensed, proprietary criteria relevant to particular treatments and services to insureds, prospective insureds and health care providers upon request.