New York S04721 amends the public health and insurance laws to deem a utilization review agent's failure to make a timely determination as approval.
New York S04721 amends the public health and insurance laws to establish that if a utilization review agent fails to make a determination within specified time periods, it shall be deemed an approval of the health care services. This applies to step therapy protocols and override determinations. The bill also specifies that failure to comply with step therapy protocol requirements can be a basis for granting an override, excluding cases of fraud. The changes take effect on the same date as specified in chapter 641 of the laws of 2024.
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- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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