Arizona HB2407 regulates health insurers' downcoding practices and establishes an appeals process for affected health care providers.
Arizona HB2407 amends state law to regulate health insurers' downcoding practices, which involve altering service codes to reduce payments. The bill prohibits insurers from using automatic processes for downcoding and mandates a documented review by a licensed health care professional of the same specialty. It also requires insurers to notify providers of downcoded claims, provide clear appeal processes, and allow batch appeals for similar claims.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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