Massachusetts insurance appeal rights

The Massachusetts Division of Insurance and the Office of Patient Protection (OPP) at the Health Policy Commission jointly oversee appeal rights; OPP administers external review.

Internal appeal rights

Internal appeal: 180 days. Response 30 days standard, 72 hours urgent.

External review

Massachusetts external review is administered by the Office of Patient Protection through state-certified IROs and binds the carrier.

MA regulator

Massachusetts Division of Insurance. official site

Notable

Office of Patient Protection: 800-436-7757 — handles external review filings.
Massachusetts has expansive infertility and behavioral health coverage mandates.

Filed a denial in Massachusetts?

We work under MA rules and structure the appeal under the strongest available state and federal protections.

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State law information is provided for general guidance and is not legal advice. Confirm with your state regulator or a licensed attorney for your specific case.