S04833Introduced in the Senate
Ensures the decision to downcode an insurance claim is recognized as an adverse determination; prohibits health plans from reversing or altering medical necessity determinations made by a utilization review agent or external appeals agent as a result of an audit of claims.
Introduced by James Skoufis, District 42
What does this bill do?
Plain-English breakdown
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Official description
Ensures the decision to downcode an insurance claim is recognized as an adverse determination; prohibits health plans from reversing or altering medical necessity determinations made by a utilization review agent or external appeals agent as a result of an audit of claims.
Where it stands
REFERRED TO INSURANCE
January 7, 2026
How did lawmakers vote?
No recorded vote is available for this bill yet.
What do people think?
Citizen Voice
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Bill history
REFERRED TO INSURANCE
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