AB 2431: Downcoding medical claims.

The bill aims to regulate downcoding practices in healthcare, where payers unilaterally alter service or procedure codes on claims to lower payments. The bill would require plans and insurers to set forth requirements and limitations for downcoding decisions and provide specified information to billing providers for disputing downcoded claims. It prohibits plans and insurers from using downcoding practices in a discriminatory manner against certain physicians, and authorizes departments to take action against plans or insurers that engage in discriminatory downcoding. The bill also requires plans and insurers to reimburse billing providers for downcoded claims.