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Proposed legislation could make California one of only a handful of states that require insurers to disclose denial rates and reasoning, which the industry often considers proprietary information. Senate Bill 363 seeks to force insurers to be more judicious with denials by fining them up to $1 million per case if more than half of appeals filed with regulators are overturned in a year.
“When you have health insurance, you should have confidence that it’s going to cover your health care needs,” Democratic Sen. Scott Wiener of San Francisco, who introduced the bill, told the Los Angeles Times. “They can just delay, deny, obstruct and, in many cases, avoid having to cover medically necessary care, and it’s unacceptable.”
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