The bill amends Chapter 27-18.9 of the General Laws, known as the "Benefit Determination and Utilization Review Act," by adding a new section, 27-18.9-16, which establishes a presumption of medical necessity for healthcare services or procedures authorized by a provider. Under this new provision, any healthcare service or procedure that a provider recommends to a patient will be presumed to be medically necessary. Consequently, it will be the responsibility of the insurance company to provide justification for any denial of coverage for such services or procedures.

This legislative change aims to shift the burden of proof onto insurance companies, requiring them to demonstrate that a healthcare service is not medically necessary if they choose to deny coverage. The act is set to take effect immediately upon passage.