AB 510: Health care coverage: utilization review: peer-to-peer review.

This bill allows patients to request a peer-to-peer review of a decision made by a health care service plan or health insurer to delay, deny, or modify a health care service request based on medical necessity. A licensed physician or health care professional of the same or similar specialty as the requesting provider can review the decision. The review must occur within 2 business days or as soon as possible for an imminent and serious health threat. If the health care service plan or health insurer fails to meet the timelines, the request is deemed approved. The bill also requires that these reviews be conducted in a timely manner, taking into account the nature of the patient's condition.