Relates to downcoding on initial review and audits reversing or altering medical necessity determinations
Summary
Ensures the decision to downcode an insurance claim is recognized as an adverse determination; prohibits health plans from reversing or altering medical necessity determinations made by a utilization review agent or external appeals agent as a result of an audit of claims.
Bill status
in committee
1 of 4 stages cleared
Introduction
May 2023
Committee Review
Floor Vote
Governor
Introduced May 9, 2023
Last action Jan 3, 2024
Floor votes
How they voted
No floor votes recorded yet.
Full legislative history
Actions timeline
Total actions
2
Key actions
0
Committee
2
Jan 3, 2024
Assembly · Referred to committee
REFERRED TO INSURANCE
May 9, 2023
Assembly · Referred to committee
REFERRED TO INSURANCE
1 primary · 0 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
David Weprin
DDemocratic
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