Proposed S.B. No. 87
Session Year 2023
AN ACT CONCERNING ADVERSE DETERMINATION AND UTILIZATION REVIEWS.
To: (1) Redefine "clinical peer" for the purposes of adverse determination and utilization reviews; (2) require health carriers to bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; and (3) require health carriers to provide certain clinical peers with authority to reverse initial adverse determinations.