This bill introduces a new section on post-acute care prior authorization in various chapters of the General Laws related to health insurance. It defines "post-acute care services" as specialized behavioral, medical, rehabilitative, or homecare services provided to patients discharged from acute care hospitals to improve their functional independence and manage ongoing health conditions.

The bill mandates that all individual or group health insurance contracts, as well as hospital or medical expense insurance policies delivered, issued for delivery, or renewed in the state on or after January 1, 2027, must provide coverage for these post-acute care services for a minimum of seven days without requiring preauthorization. However, the discharging hospital is required to notify the insurer prior to discharge and admission to post-acute care. Utilization review procedures may be initiated on the seventh day.

Medical necessity for post-acute care services will be determined by the treating healthcare provider and documented in the patient's medical record and discharge plan. The act will take effect upon passage.