California AB512 regulates prior authorization decisions for health care services by insurers and health care service plans.

California AB512 mandates that insurers and health care service plans make timely decisions on prior authorization requests for health care services, not exceeding 72 hours. It requires these entities to develop criteria and guidelines for such decisions, involving actively practicing health care providers and adhering to clinical principles. The bill also mandates that insurers and plans disclose their criteria and guidelines to insureds and providers upon request.

California AB512 regulates prior authorization decisions for health care services by insurers and health care service plans.

California AB512 mandates that insurers and health care service plans make timely decisions on prior authorization requests for health care services, not exceeding 72 hours. It requires these entities to develop criteria and guidelines for such decisions, involving actively practicing health care providers and adhering to clinical principles. The bill also mandates that insurers and plans disclose their criteria and guidelines to insureds and providers upon request.