AB 510 (Addis, D-San Luis Obispo)

AB 510 would require that any appeal or grievance for a health plan’s denial or modification of a service based on medical necessity be reviewed by a licensed physician within two business days — or within a timely fashion appropriate for the nature of the insured’s condition if the insured faces imminent or serious threat to their health. If the plan fails to meet the deadline, the bill would deem the prior authorization request approved.