May 19, 2015
On May 5, 2015, Gov. Bullock signed SB 83 into law, creating chapter 428. The legislation adopts the NAIC External Review Model Law to provide uniform standards for the establishment and maintenance of external review procedures to assure that covered persons have the opportunity for an independent review of an adverse determination or final adverse determination.
The new legislation is intended to create transparency and accountability in the appeals process for health care treatment decisions by adopting and revising processes that provide for utilization review, grievances and external review of health insurance issuer’s actions. The legislation will also create a uniform structure of appeals for all health plan issuers, and prioritize appeals that may have life and death consequences. Chapter 428 is effective Jan. 1, 2016.
Chapter 428 »