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Providence

Boston

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Boston, MA 02108

T 617.720.5090
F 617.720.5092

Providence

One Cedar Street
Suite 300
Providence, RI 02903
T 401.454.0400
F 401.454.0404

Leading legislative reforms to improve transparency of patient reviews

Ch. 224 Section 199 – Enhanced transparency of health insurance medical necessity and clinical review policies.

Insurers act as the financial gateway to almost all health care services provided within the Commonwealth. Each company uses a set of policies and criteria to determine when they will provide or deny an enrollee coverage for a service recommended by their health care provider. Such policies can dramatically influence a patient’s care, yet they have remained largely unknown to patients and their caregivers. The legislation took an important step by requiring all clinical and medical necessity policies be made available and easily accessible to enrollees and care providers. Just another example of the many important reforms—championed by the government relations team at Donoghue Barrett & Singal—that can streamline inefficiencies in the health care system and improve the patient experience.

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Donoghue Barrett & Singal Secures DPH Approval for Major Health System…

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Helping clients successfully navigate health care regulation

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Clearing the path for a state-of-the-art hospital in Charlestown

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Landmark ruling in scientific misconduct case

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Health care reform: standardizing insurer review procedures

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Giving back to our community

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Significant appeal in Big Dig criminal case