Massachusetts legislation · 194th General Court
Massachusetts H4616: An Act improving the health insurance prior authorization process
Status: In committee, July 29, 2026
What the bill says
From the introduced text, October 20, 2025:
SECTION 1. Chapter 26 of the General Laws is hereby amended by inserting after section 8M the following section:- 8N. (a) All carriers licensed under chapters 175, 176A, 176B and 176G that provide medical or prescription drug benefits subject to utilization review consistent with section 12 of chapter 176O, shall make publicly available on their website a searchable list of all items, services and medications that require prior authorization. Prior authorization may not be requested for an item, service or medication that is not listed on the publicly available website. (b) If a carrier contracts with another entity that manages or administers such benefits for the carrier, including a utilization review organization as defined in section 1 of said chapter 176O, that entity shall provide the carrier the information required under subsection (a) and that carrier shall post the required information publicly on the carrier’s website consistent with the requirements of subsection (a). (c) Carriers and utilization management organizations shall report annually, not later than July 1, to the division of insurance data regarding approval and denials of prior authorization requests, including request for drug benefits, in a readily accessible, standardized, searchable format as determined by the division. Data shall be submitted for the following categories: medical, inpatient and outpatient surgical services, post-acute care admissions to skilled nursing facilities, inpatient …
Sponsors
- Services, Joint Committee on Financial (I) · primary sponsor
- Natalie Blais (D, 1st Franklin)
- Natalie Higgins (D, 4th Worcester)
- Danillo Sena (D)
- Jennifer Armini (D)
- Carmine Gentile (D)
- John Moran (D, 9th Suffolk)
- Tram Nguyen (D, 18th Essex)
- James Arena-DeRosa (D)
- Thomas Moakley (D)
- David Rogers (D, 24th Middlesex)
- Hadley Luddy (D)
Latest actions
- : Committee recommended bill ought to pass and referred to the committee on House Ways and Means
- : Reporting date extended to Friday, July 31, 2026
- : Reporting date extended to Monday, June 15, 2026
- : Reporting date extended to Wednesday, March 18, 2026
- : Reported favorably by committee and referred to the committee on Health Care Financing
- : New draft of H1136
- : Reported from the committee on Financial Services
Votes
- Committee Vote - Joint Committee on Health Care Financing (July 16, 2026): 13 yea, 0 nay, passed
- Committee Vote - Joint Committee on Financial Services (October 9, 2025): 11 yea, 0 nay, passed
Common questions
- What is H4616?
- H4616 is a bill in the Massachusetts Legislature (194th General Court): An Act improving the health insurance prior authorization process.
- What is the status of H4616?
- In committee as of July 29, 2026. Latest action: Committee recommended bill ought to pass and referred to the committee on House Ways and Means (July 29, 2026).
- Who sponsored H4616?
- Services, Joint Committee on Financial (I), with 11 co-sponsors.
- Where is the official record for H4616?
- On the Massachusetts Legislature website: https://malegislature.gov/Bills/194/H4616
Source: official Massachusetts record. Tracked by Delilah, AI for legislation across all 50 states and Congress.