Relating to managing the utilization of health services.
Summary
Imposes restrictions and reporting requirements for utilization management of health services by commercial insurers, coordinated care organizations and state medical assistance program. ] Creates new requirements applicable to prior authorization, step therapy and other utilization review policies and procedures on insurers offering health benefit plans and health insurance, medical services contracts, multiple employer welfare arrangements, health care service contracts and pharmacy benefit managers. Extends from 30 to 90 days period during which insurer's approval of prior authorization is binding on insurer. Authorizes provider to act on behalf of enrollee, upon request of enrollee, with respect to internal appeals and external reviews of adverse benefit determination concerning utilization review. Requires insurers offering health benefit plans to report specified information to Department of Consumer and Business Services regarding requests for prior authorization.
Bill status
in committee
1 of 4 stages cleared
Introduction
Jan 2019
Committee Review
Floor Vote
Governor
Introduced Jan 14, 2019
Last action Jul 1, 2019
Floor votes
How they voted
No floor votes recorded yet.
Full legislative history
Actions timeline
Total actions
8
Key actions
2
Committee
4
Jul 1, 2019
Upper · Passed
In committee upon adjournment.
upper
Apr 15, 2019
Committee
Referred to Ways and Means by order of the President.
upper
Apr 15, 2019
Upper · Passed
Recommendation: Do pass with amendments and be referred to Ways and Means. (Printed A-Eng.)
upper
Jan 15, 2019
Committee
Referred to Health Care.
upper
Jan 14, 2019
Introduced
Introduction and first reading. Referred to President's desk.
upper
0 primary · 0 co-sponsors
Sponsors
No sponsor information available.
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