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2010 SESSION

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HB 11 Health care services; peer utilization reviews on reconsideration of an adverse decision.

Introduced by: Robert G. Marshall | all patrons    ...    notes | add to my profiles

SUMMARY AS PASSED HOUSE: (all summaries)

Health services; peer utilization reviews. Clarifies that a health care provider may seek reconsideration or appeal of an adverse health care utilization review decision, and that written notification of an adverse decision must include instructions for requesting reconsideration or an appeal. This bill also provides that when a treating provider requests a peer review of an adverse decision during the reconsideration process, the request for reconsideration shall be vacated and the request shall be considered a request for an appeal, and that in any case under appeal, the case shall be reviewed by a peer of the health care provider proposing the treatment at issue who shall be board certified in the same or similar specialty as the treating health care provider. This bill contains a delayed enactment clause, and shall not become effective until October 1, 2010.


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