AN ACT CONCERNING HEALTH COVERAGE.
To: (1) require certain health insurers, preferred provider networks and other entities to include certain provisions in contracts with health care providers regarding reimbursement for certain covered health benefits, (2) clarify the definition of "anti-steering clause" under section 38a-477i of the general statutes, (3) require the Insurance Commissioner to conduct a study concerning various revisions to the insurance statutes, (4) change the time period that a health carrier and participating provider shall continue to abide by the terms of a contract under section 38a-472f of the general statutes, (5) prohibit a health carrier from using a software tool to downcode or deny certain health insurance claims, (6) establish a rebuttable presumption for purposes of the review of an adverse determination under section 38a-591e of the general statutes, and (7) prohibit certain health carriers from requiring step therapy for prescription drugs used to treat a chronic, disabling or life-threatening condition.
Introduced by:
Insurance and Real Estate Committee
