This bill amends the Wyoming insurance code to modify the timelines for health insurers and independent review organizations regarding the determination of medical necessity for health care services. Specifically, it changes the period within which a health insurer must complete a review and deliver a decision to a claimant from forty-five days to twenty-one days after receiving a request for review. Additionally, the bill stipulates that an independent review organization must provide written notice of its decision regarding the medical necessity of services within twenty-one days of receiving the request for external review, also reducing the previous timeline of forty-five days.

The effective date for these changes is set for July 1, 2026. The amendments aim to expedite the review process for claimants seeking determinations on the medical necessity of their health care services, thereby enhancing the efficiency of the claims process in the state.

Statutes affected:
Introduced: 26-40-201