Clawback Testimony

In December of 2015, CliniciansUNITED members, staff, and bill sponsor Representative Jim O’Day testified in support of House Bill 925, An Act to Limit Retroactive Denials of Health Insurance Claims for Mental Health and Substance Abuse Services. This bill will:

• Limit both MassHealth and commercial health insurers to a six month period for recovering payments to a provider for services completed. When providers deliver a service in good faith and in compliance with eligibility rules, they should be compensated without fear of insurance companies taking back these reimbursements years or months after the services were provided.

• Require that MassHealth institute a back-end process to reconcile payment between payers without involving the provider. This process could mirror the current process in the auto insurance industry.

To read our submitted testimony, click here

For more information about the bill, click here for the fact sheet. 

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