New York S07297 amends health law and insurance law to require utilization review agents to use evidence-based and peer-reviewed clinical criteria.

New York S07297 amends the public health law and the insurance law to establish new standards for utilization review programs. It mandates that utilization review agents must use evidence-based and peer-reviewed clinical criteria when making determinations for health care services requiring pre-authorization. The bill also requires agents to notify enrollees and their health care providers of these determinations within specific timeframes.

New York S07297 amends health law and insurance law to require utilization review agents to use evidence-based and peer-reviewed clinical criteria.

New York S07297 amends the public health law and the insurance law to establish new standards for utilization review programs. It mandates that utilization review agents must use evidence-based and peer-reviewed clinical criteria when making determinations for health care services requiring pre-authorization. The bill also requires agents to notify enrollees and their health care providers of these determinations within specific timeframes.