Loading chat...
MO SB761
Bill
Status
Introduced
1/22/2014
Primary Sponsor
Wayne Wallingford
Click for details
AI Summary
- Reduces initial utilization review determination timeframe from two working days to 24 hours for health carriers to make decisions on proposed admissions, procedures, or services
- Requires health carriers to notify providers by telephone or electronically within 24 hours of certifying services and within one working day for adverse determinations
- Establishes that "serious and urgent condition" includes inadequately controlled undiagnosed pain, risks of disease progression or bodily dysfunction, or serious health risks from delayed diagnostic testing, and prohibits prior authorization requirements for such services
- Requires health carriers to provide authorization decisions within 60 minutes for post-emergency or post-stabilization services, with automatic approval if decision is not made within 30 minutes
- Mandates written notification of adverse determinations include principal reasons, appeal instructions, and clinical rationale with review criteria used
Legislative Description
Modifies requirements for insurance benefit determinations by a health carrier
Last Action
Hearing Conducted S Small Business, Insurance and Industry Committee
2/18/2014
Committee Referrals
Small Business, Insurance And Industry2/13/2014
Full Bill Text
No bill text available