Loading chat...
NY S06920
Bill
Status
5/20/2021
Primary Sponsor
Neil Breslin
Click for details
AI Summary
-
Amends Public Health Law Section 4903 to change the default outcome when a utilization review agent fails to make a determination within prescribed timeframes from an adverse determination to an approval of the requested health care services.
-
Amends Insurance Law Section 4903 with the same change, establishing that missed utilization review deadlines automatically constitute approval rather than denial.
-
Preserves the requirement that failure to meet timeframes for step therapy protocols shall be deemed an override of the step therapy protocol, applying to both public health and insurance law provisions.
-
Takes effect on the thirtieth day after becoming law.
Legislative Description
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.
Last Action
COMMITTED TO RULES
6/3/2022