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
Feb 2025
Committee Review
Floor Vote
Governor
Introduced Feb 13, 2025
Last action Jan 7, 2026
Floor votes
How they voted
No floor votes recorded yet.
Full legislative history
Actions timeline
Total actions
2
Key actions
0
Committee
2
Jan 7, 2026
Committee
REFERRED TO INSURANCE
upper
Feb 13, 2025
Committee
REFERRED TO INSURANCE
upper
1 primary · 1 co-sponsor
Sponsors
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