New York A07292 requires health maintenance organizations to inform insureds of preferred alternative treatments or past ineffectiveness when denying.

New York A07292 amends the insurance law by adding a new section that mandates health maintenance organizations to provide specific information when denying a claim. If a health maintenance organization denies coverage for a procedure or treatment due to a lack of medical necessity, it must inform the insured of preferred alternative treatment options that would be covered. Alternatively, the organization must provide a statement detailing the past ineffectiveness of the requested procedure or treatment.

New York A07292 requires health maintenance organizations to inform insureds of preferred alternative treatments or past ineffectiveness when denying.

New York A07292 amends the insurance law by adding a new section that mandates health maintenance organizations to provide specific information when denying a claim. If a health maintenance organization denies coverage for a procedure or treatment due to a lack of medical necessity, it must inform the insured of preferred alternative treatment options that would be covered. Alternatively, the organization must provide a statement detailing the past ineffectiveness of the requested procedure or treatment.