A6937 (2023-24 session)
NY State bill
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.
- Title
- Relates to downcoding on initial review and audits reversing or altering medical necessity determinations
- Type
- New York State Assembly bill
- Session
- 2023-24 session
- Status
- In Assembly Committee
- Latest action date
- 2024-01-03
- In committee
- Insurance
- Introduced
- 2023-05-09
- Law section
- Insurance Law
Sponsors
- David I. Weprin Assembly Member, District 24
Heard in committee
- Insurance NY State Assembly committee