This is not the official budget document.

Budget Summary FY2015

Outside Section 18
Data Current as of:  10/17/2014




Previous Outside Section Next Outside Section

 

Health insurance criteria and protocol availability I

SECTION 18.   Subsection (a) of section 16 of chapter 6D of the General Laws, as appearing in the 2012 Official Edition, is hereby amended by striking out the fifth sentence and inserting in place thereof the following 2 sentences:- Utilization review criteria, medical necessity criteria and protocols shall be made available upon request to the office and the division of insurance; provided, however, that licensed, proprietary criteria and protocols purchased by a carrier shall not be public records and shall be exempt from disclosure pursuant to clause Twenty-sixth of section 7 of chapter 4 and section 10 of chapter 66. Utilization review criteria, medical necessity criteria and protocols shall be made available to the public at no charge; provided, however, that licensed, proprietary criteria purchased by a carrier or utilization review organization shall not be made available to the public, but such licensed, proprietary criteria relevant to particular treatments and services shall be provided to insureds, prospective insureds and health care providers upon request.