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.
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.
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.
Relating to utilization review and notice and appeal of certain adverse determinations by utilization review agents.
Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
An Act Concerning Step Therapy, Adverse Determination And Utilization Reviews.
An Act Concerning Utilization Review And Health Care Contracts, Health Insurance Coverage For Newborns And Step Therapy.