New Law Allows Massachusetts Patients to Appeal Denials of Care

Massachusetts' new patients' bill of rights, which gives some consumers the ability to appeal denials of care by their health plans, took effect Jan. 1, the Boston Herald reports. Under the law, subscribers to "most health plans" can seek an external review, after first pursuing an appeal through their insurer's "internal grievance system." Medicare, Medicaid and self-insured patients are not covered by the law. Insurers have 30 days after receiving a patient's complaint to complete an internal review, and patients have 45 days after the insurer makes a decision to request an external review, which will cost $25. The new regulations will be implemented by the state's Division of Insurance and Department of Public Health. The public health department has contracted with two New York-based private firms, the Center for Health Dispute Resolution and the Island Professional Review Association, to conduct the external reviews. The firms' decisions "will be binding and must be ready in 60 days" (Lasalandra, Boston Herald, 1/3).