Requires insurers and health plans to grant automatic preauthorization approvals to eligible health care professionals in certain circumstance

Bill S 7470 requires health insurers and plans to grant automatic preauthorization approvals to eligible health care professionals for specific services. A health care professional qualifies for this if an insurer has approved at least 90% of their preauthorization requests for that particular service during the most recent six-month evaluation period. Once a professional has automatic approval, the corresponding health care service is deemed medically necessary, and the insurer must promptly pay the full claim without denial, reduction, or retroactive recoupment. Insurers are required to conduct initial and annual evaluations to determine eligibility for these automatic approvals.