Provides that the failure by the utilization review agent to make a determination within certain time periods shall be deemed to be an approval of the health care services.
Same As
Provides that the failure by the utilization review agent to make a determination within certain time periods shall be deemed to be an approval of the health care services.
Provides that the failure by the utilization review agent to make a determination within certain time periods shall be deemed to be an approval of the health care services.
Relates to the use of artificial intelligence by insurers and clinical peer reviewers for utilization review; establishes additional notice requirements for adverse determinations.
Requires that a contract between an insurer and a hospital shall include a provision that provides for medical records requested by the insurer or its utilization review agent to be made available electronically by the hospital; limits the use of disclosed records.
Requires that a contract between an insurer and a hospital shall include a provision that provides for medical records requested by the insurer or its utilization review agent to be made available electronically by the hospital; limits the use of disclosed records.
Provides that certain utilization review determinations shall be made consistent with medical and scientific evidence; includes services for mental health and substance use disorders as part of emergency services.
Provides that certain utilization review determinations shall be made consistent with medical and scientific evidence; includes services for mental health and substance use disorders as part of emergency services.