Health care services; peer utilization reviews on reconsideration of an adverse decision. (HB11)

Introduced By

Del. Bob Marshall (R-Manassas)

Description

Health services; peer utilization reviews.  Requires that a decision on reconsideration of an adverse decision in which it is determined that a health service was or is not medically necessary, and which may result in noncoverage of a health service, be made by a peer of the treating health care provider.  Physician advisors and panels of other appropriate health care providers will no longer be permitted to decide requests for reconsideration.  If the denied health service was recommended by a doctor of medicine, a peer of the treating health care provider shall be a physician who holds a nonrestricted license to practice medicine in the Commonwealth or under a comparable licensing law of another state and who maintains the same or similar scope of practice or specialty or subspecialty as the treating health care provider.   View Full Text »

Outcome

Comments

No Richmond Sunlight visitors voted on this bill while voting was open.