A3707 (2025-26 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
2025-26 session
Status
In Assembly Committee
Latest action date
2026-01-07
In committee
Insurance
Introduced
2025-01-30
Same as
S4833
Law section
Insurance Law

Sponsors

Co-sponsors

Heard in committee

Sources