Health Care Access Bureau

Created as part of the health care reform legislation of 2006, the Health Care Access Bureau is responsible for regulatory oversight of the small group and individual health insurance markets, and of affordable health plans. The Bureau disseminates information to consumers relative to health insurance coverage and, specifically, access to affordable insurance products.

Health Care Coverage Information

Coverage Information

Standard Prior Authorization Forms

Prior authorization forms when reviewing requests for service according to M.G.L. c. 176O, 25(c).

• Standard Prior Authorization Form for ABA Services
• Oncology Prior Authorization Form
• Behavioral Health Disorders - Level of Care Request Form
• Repetitive Transcranial Magnetic Simulation Request Form
• Psychological and Neuropsychological Assessment Supplemental Form
• Massachusetts Standard Form for Medication Prior Authorization Request
• Cardiac Imaging Prior Authorization Form to be used with Myocardial Perfusion Imaging (MPI); Stress Echocardiogram; Multiple Gated Acquisition Scan (MUGA); Transthoracic Echocardiogram (TTE); Transesophageal Echocardiogram (TEE)
• PET - PET CT Prior Authorization Form
• CT/CTA/MRI/MRA Prior Authorization Form
• Massachusetts Standard Form for Hepatitis C Medication Prior Authorization Requests
• Non-OB Ultrasound Authorization Form
• Massachusetts Standard Form for SYNAGIS Prior Authorization Requests 

 

Annual Comprehensive Financial Statements

Financial Summary of the Market for Health Insurance Annual Reports

The 2010-2018 Annual Comprehensive Financial Statements for each health carrier can be viewed at the Division’s Public Document Room.  The summaries of 2010-2018 are shown below.

• 2018 Annual Comprehensive Financial Statement Summary Report
• 2017 Annual comprehensive Financial Statement Summary Report 
• 2016 Annual Comprehensive Financial Statement Summary Report 
• 2015 Annual Comprehensive Financial Statement Summary Report 
• 2014 Annual Comprehensive Financial Statement Summary Report 
• 2013 Annual Comprehensive Financial Statement Summary Report
• 2012 Annual Comprehensive Financial Statement Summary Report 
• 2011 Annual Comprehensive Financial Statement Summary Report 
• 2010 Annual Comprehensive Financial Statement Summary Report 
• Comparison 2010 - 2011 Annual Comprehensive Financial Statement Summary Reports 

Summary of Certifications of Compliance with MHPAEA

• Summary of 2021 Certifications of Compliance with MHPAEA
• Summary of 2020 Certifications of Compliance with MHPAEA
• Summary of 2019 Certifications of Compliance with MHPAEA
• Summary of 2018 Certifications of Compliance with MHPAEA
• Summary of 2017 Certifications of Compliance with MHPAEA
• Summary of 2016 Certifications of Compliance with MHPAEA
• Summary of 2015 Certifications of Compliance with MHPAEA
• Summary of 2014 Certifications of Compliance with MHPAEA
• Summary of 2013 Certifications of Compliance with MHPAEA
• Summary of 2012 Certifications of Compliance with MHPAEA
• Special Examination of Carriers Compliance with Certain MHPAEA Provisions

Reports and Publications

• 2022 Report of Insured Dental Coverage in Massachusetts
• The Catalogue of Carrier Coverage of Inpatient, Outpatient and Community Behavioral Health Services 11/10/17
  • PDF   EXCEL  
• Contraceptive Coverage by Carrier Survey Results 5/31/16
  • PDF   EXCEL 
• Tobacco Cessation Product Coverage by Carrier - Survey Results 11/10/15
  • PDF   EXCEL 
• 2010 Accident-Only Insurance Survey Results
• 2010 Disability Income Insurance Survey Results
• 2010 Hospital Indemnity Insurance Survey Results
• 2010 Long Term Care Insurance Survey Results
• Analysis of Wellness and Health Management Programs
• Gorman Actuarial's Long-Term Care Insurance Survey Report  
• Medical Malpractice Insurance In The Massachusetts Market Report
• Compendium of Testimony & Related Information - Investigation and Study of the Costs of Medical Malpractice Insurance for Health Care Providers  
• Analysis of Administrative Expenses for Health Insurance Companies in Massachusetts  
• Trends in Health Claims for Fully-Insured, Health Maintenance Organizations in Massachusetts, 2002-2006  
• Mercer's National Survey of Employer-Sponsored Health Plans For the Massachusetts Division of Insurance 2007  
• Impact of Merging the Massachusetts Non-Group and Small Group Health Insurance Markets