Section 54

Section 54 Retroactive Claims Denials for Behavioral Health Services 4

Said section 1 of said chapter 175, as so appearing, is hereby further amended by inserting after the definition of "Resident" the following definition:-

"Retroactive claims denial", an action by an insurer, an entity with which the insurer subcontracts to manage behavioral health services or an entity with which the insurer has entered into an administrative services contract or a contract to manage behavioral health services to deny a previously paid claim for such services and to require repayment of the claim or to impose a reduction in other payments or otherwise withhold or affect future payments owed to a provider in order to recoup payment for the denied claim.