Same As
Requires written notice of an adverse determination made by a utilization review agent in relation to a step therapy protocol override determination.
Relates to the use of artificial intelligence by insurers and clinical peer reviewers for utilization review; establishes additional notice requirements for adverse determinations.
Relates to the use of artificial intelligence by insurers and clinical peer reviewers for utilization review; establishes additional notice requirements for adverse determinations.
Hospital and Medical Services Utilization Review Act; requiring utilization review organization that uses AI to adhere to requirements; prohibiting AI from making certain determinations. Effective date.