Bill Text: CT HB05387 | 2012 | General Assembly | Comm Sub

---

Bill Title: An Act Concerning Health Insurance Claim Forms And The Development Of A Uniform Treatment Authorization Form For Mental Health Services.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2012-04-11 - Tabled for the Calendar, House [HB05387 Detail]

Download: Connecticut-2012-HB05387-Comm_Sub.html

---

General Assembly		Raised Bill No. 5387
February Session, 2012		LCO No. 1683
		*_____HB05387PH____041112____*
Referred to Committee on Insurance and Real Estate
Introduced by:
(INS)

AN ACT CONCERNING HEALTH INSURANCE CLAIM FORMS AND THE DEVELOPMENT OF A UNIFORM TREATMENT AUTHORIZATION FORM FOR MENTAL HEALTH SERVICES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsections (a) and (b) of section 38a-477 of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2012):

(a) Except where there is an agreement to the contrary between a third-party payer and the health care provider, as defined in section 19a-17b, all health care providers shall submit all third-party claims for payment on the current standard Health Care Financing Administration Fifteen Hundred (HCFA1500) health insurance claim form or its successor, or in the case of a hospital or other health care institution, a Health Care Financing Administration UB-92 health insurance claim form or its successor, or in accordance with other forms [which] that may be prescribed by the Insurance Commissioner. With respect to the Health Care Financing Administration Fifteen Hundred health insurance claim form or its successor or other form prescribed by the commissioner for third-party claims for payment, a health care provider shall be allowed to use a National Provider Identifier assigned to such provider by the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System in lieu of such provider's federal tax identification number.

(b) For any claim submitted to an insurer on the current standard Health Care Financing Administration Fifteen Hundred health insurance claim form or its successor, if the following information is completed and received by the insurer, the claim may not be deemed to be deficient in the information needed for filing a claim for processing pursuant to subparagraph (B) of subdivision (15) of section 38a-816.

T1	Item Number	Item Description
T2	1a	Insured's identification number
T3	2	Patient's name
T4	3	Patient's birth date and sex
T5	4	Insured's name
T6	10a	Patient's condition - employment
T7	10b	Patient's condition - auto accident
T8	10c	Patient's condition - other accident
T9	11	Insured's policy group number
T10		(if provided on identification card)
T11	11d	Is there another health benefit plan?
T12	17a	Identification number of referring physician
T13		(if required by insurer)
T14	21	Diagnosis
T15	24A	Dates of service
T16	24B	Place of service
T17	24D	Procedures, services or supplies
T18	24E	Diagnosis code
T19	24F	Charges
T20	25	Federal tax identification number
T21		or National Provider Identifier
T22	28	Total charge
T23	31	Signature of physician or supplier with date
T24	33	Physician's, supplier's billing name,
T25		address, zip code & telephone number

Sec. 2. (Effective from passage) Not later than January 1, 2013, the Commissioner of Public Health, in consultation with the Insurance Commissioner, the Commissioner of Mental Health and Addiction Services, the Attorney General and the Healthcare Advocate, shall develop a uniform treatment authorization form for mental health services. Such form shall (1) be used by health care providers and hospitals in this state to obtain patient authorization and information for the provision of mental health services, (2) meet, at a minimum, privacy standards set forth in state and federal privacy laws, including, but not limited to, the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended from time to time, and any regulations adopted thereunder, and (3) comply with state and federal mental health parity laws. Not later than January 15, 2013, the Commissioner of Public Health shall submit any proposed legislation the Commissioner of Public Health deems necessary to implement the use of such form to the joint standing committee of the General Assembly having cognizance of matters relating to public health.

This act shall take effect as follows and shall amend the following sections:
Section 1	October 1, 2012	38a-477(a) and (b)
Sec. 2	from passage	New section

INS	Joint Favorable
PH	Joint Favorable