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A06937 Summary:
| BILL NO | A06937 |
| SAME AS | No Same As |
| SPONSOR | Weprin |
| COSPNSR | |
| MLTSPNSR | |
| Amd 3224-b, 3224-a & 4900, Ins L; amd 4900, Pub Health L | |
| 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. | |