SB 1574

Bill Subjects

Abstract

Health Care Services; Revising the definitions of the terms “health insurer” as “utilization review entity”; requiring utilization review entities to establish and offer a prior authorization process for accepting electronic prior authorization requests by a specified date; prohibiting payment adjudicators from downcoding health care services under certain circumstances; requiring payment adjudicators to provide certain information prior to making their initial payment or notice of denial of payment, etc.