HB3137: Health coverage; expedited review of appeals of final adverse decisions.

Chief Patron

Del. Bill Fralin (R-17)

Bill Fralin (R-17)
Roanoke, VA
Served: 2004–

Progress

	Introduced
	Passed Committee
	Passed House
	Passed Senate
	Signed by Governor
	Became Law

Status

03/13/2007: signed by governor

View Entire History

Summary

Expedited review of final adverse health coverage decisions.  Establishes requirements for an expedited review by impartial health entities conducting reviews of final adverse decisions regarding the coverage of health care services. If the regular process for reviewing a final adverse decision will delay the rendering of treatment for a patient whose condition would be terminal without the treatment, the impartial health entity shall issue its recommendation no later than one business day following the receipt by the impartial health entity of all necessary information. Currently, the entity has 30 working days to make its recommendation. The measure also requires the Commissioner of Insurance or his designee to issue a final ruling no later than three business days following the receipt of the impartial health entity's recommendation if the regular process for the issuance of a ruling will delay the rendering of for a patient whose condition would be terminal without the treatment. Currently, he has 10 working days to issue his final ruling.