AB510 mandates expedited peer-to-peer reviews for health care service disputes in California.

AB510 amends California's Health and Safety Code to require health care service plans to resolve grievances within 30 days, with expedited peer-to-peer reviews for cases involving imminent and serious threats to health. Peer-to-peer reviews must occur within two business days, or 24 hours for urgent cases. The bill also mandates that insurers connect providers directly with peer physicians or health care professionals for these reviews. Insurers must report annually on their dispute resolution mechanisms, and plans must inform enrollees of their grievance rights in writing.

AB510 mandates expedited peer-to-peer reviews for health care service disputes in California.

AB510 amends California's Health and Safety Code to require health care service plans to resolve grievances within 30 days, with expedited peer-to-peer reviews for cases involving imminent and serious threats to health. Peer-to-peer reviews must occur within two business days, or 24 hours for urgent cases. The bill also mandates that insurers connect providers directly with peer physicians or health care professionals for these reviews. Insurers must report annually on their dispute resolution mechanisms, and plans must inform enrollees of their grievance rights in writing.