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A03707 Summary:
BILL NO | A03707 |
SAME AS | SAME AS S04833 |
SPONSOR | Weprin |
COSPNSR | Kassay |
MLTSPNSR | |
Amd §§3224-b, 3224-a & 4900, Ins L; amd §4900, Pub Health L | |
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. |