AB 1268 – California

Status: Inactive / Dead
Year Introduced: 2019
Link: https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200AB1268

Health care coverage: prospective review – This bill would require a health care service plan or health insurer, on or before July 1, 2020, and annually on July 1 thereafter, to report to the appropriate department the number of times in the preceding calendar year that it approved or denied each of the 30 health care services for which prospective review was most frequently requested. The bill would require an entity that performs utilization review or utilization management functions for a plan or insurer, or to which a plan or insurer delegates these functions, to report to the plan or insurer the number of times in the preceding calendar year that it approved or denied each of the 30 health care services for which prospective review was most frequently requested, and would require the plan or insurer to include that information in its report to the appropriate department. The bill would require a plan or insurer to take the reported information into account when evaluating its criteria used to authorize, modify, or deny health care services. The bill would require each department to determine the form and manner of that reporting.


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