An Act Decreasing The Time Frame For Certain Adverse Determination Grievances.
Impact
If enacted, this bill would directly impact the way health carriers manage grievance reviews and notifications. By mandating quicker response times, the legislation is likely aimed at reducing delays that can compromise patient care, especially in urgent situations. This change is intended to better align health insurance practices with the immediate needs of patients facing time-sensitive healthcare issues.
Summary
SB01090, titled 'An Act Decreasing The Time Frame For Certain Adverse Determination Grievances,' proposes significant amendments to existing laws regarding the timeline in which health carriers must respond to grievances about adverse determinations. The bill focuses on ensuring that covered individuals receive timely responses to their health care treatment requests. Notably, it reduces the maximum timeframe for urgent and expedited review requests from seventy-two hours to twenty-four hours, enhancing the speed at which patients can receive necessary care decisions.
Contention
While the intention behind SB01090 is to foster a more patient-centered approach within insurance protocols, there may be concerns about the feasibility of reducing review times under the existing pressures faced by health carriers. Critics might argue that such strict timelines could result in rushed decisions or operational challenges for insurers, potentially undermining thorough evaluation of complicated cases. The effectiveness of this measure will depend on the capacity of health organizations to adapt to the newly imposed time constraints.
An Act Prohibiting Certain Health Carriers From Requiring Step Therapy For Prescription Drugs Used To Treat A Mental Or Behavioral Health Condition Or A Chronic, Disabling Or Life-threatening Condition.
An Act Concerning Insurance Market Conduct And Insurance Licensing, The Insurance Department's Technical Corrections And Other Revisions To The Insurance Statutes And Captive Insurance.