North Carolina S315 enhances transparency and efficiency in health insurance utilization reviews.

North Carolina S315 mandates insurers to promptly notify policyholders and providers of utilization review decisions, especially for urgent health care services. It requires insurers to include summaries of their review procedures in materials for prospective policyholders, on membership cards, and on their websites. Insurers must also update their websites before implementing new or amended review requirements. The bill prohibits insurers from using artificial intelligence as the sole basis for denying, delaying, or modifying healthcare services.

North Carolina S315 enhances transparency and efficiency in health insurance utilization reviews.

North Carolina S315 mandates insurers to promptly notify policyholders and providers of utilization review decisions, especially for urgent health care services. It requires insurers to include summaries of their review procedures in materials for prospective policyholders, on membership cards, and on their websites. Insurers must also update their websites before implementing new or amended review requirements. The bill prohibits insurers from using artificial intelligence as the sole basis for denying, delaying, or modifying healthcare services.