WyomingInsurers and reviewers would decide medical-necessity requests within 21 days
The proposal would give insurers and independent reviewers 21 days to decide medical-necessity reviews after receiving a request.
What it does
When a claimant asks an insurer to review a medical-necessity decision, the insurer would have 21 days to finish the review and tell the claimant its decision.
An assigned independent review organization would have 21 days to tell the claimant, insurer, and insurance commissioner whether it upholds or reverses the insurer’s medical-necessity decision.
Argument forClaimants could get decisions sooner because insurers and independent reviewers would have less time to decide medical-necessity requests.
Argument againstA shorter deadline could leave insurers and reviewers less time to assess records, which might affect decisions about claimants’ requested care.
More detail
The insurer would have 21 days to finish an internal review and deliver its decision to the claimant. This applies when a claimant requests review of an insurer’s decision about whether care is medically necessary. The 21-day period would begin when the insurer receives the review request.
The assigned independent review organization would have 21 days to give written notice of its decision. The organization would notify the claimant, insurer, and insurance commissioner. The notice would tell whether the organization upholds or reverses the insurer’s decision that requested services, procedures, or supplies are not medically necessary. The 21-day period would begin when the organization receives the external-review request.
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Where it stands
- Introduced
- Passed 1st Chamber
- Died
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Mar 3H:Died in Committee Returned Bill Pursuant to HR 5-4Died
- Mar 3H No report prior to CoW Cutoff
- Feb 23H Introduced and Referred to H10 - LaborMinor
- Feb 20H Received for IntroductionMinor
- Vote recorded S 3rd Reading:Passed 29-2-0-0-0. Result: pass.Upper
- Feb 20S 3rd Reading:Passed 29-2-0-0-0Passed 1st Chamber
- Feb 19S 2nd Reading:PassedMinor
- Feb 18S COW:PassedMinor
- Feb 17S Placed on General File
- Vote recorded S10 - Labor:Recommend Do Pass 5-0-0-0-0. Result: pass.Upper
- Feb 17S10 - Labor:Recommend Do Pass 5-0-0-0-0Minor
- Feb 13S Introduced and Referred to S10 - Labor 30-1-0-0-0Minor
- Vote recorded S Introduced and Referred to S10 - Labor 30-1-0-0-0. Result: pass.Upper
- Feb 12S Received for IntroductionMinor
- Feb 11Bill Number AssignedIntroduced
Healthcare