Bill Text: CT HB05484 | 2013 | General Assembly | Comm Sub


Bill Title: An Act Concerning Health Insurance Coverage And Abuse-deterrent Prescription Medications.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2013-04-10 - Referred by House to Committee on Appropriations [HB05484 Detail]

Download: Connecticut-2013-HB05484-Comm_Sub.html

General Assembly

 

Committee Bill No. 5484

January Session, 2013

 

LCO No. 4385

 

*_____HB05484GL____031413____*

Referred to Committee on GENERAL LAW

 

Introduced by:

 

(GL)

 

AN ACT CONCERNING HEALTH INSURANCE COVERAGE AND ABUSE-DETERRENT PRESCRIPTION MEDICATIONS.

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

Section 1. Section 38a-492i of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):

(a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist that may include all means medically necessary to make a diagnosis and develop a treatment plan including the use of necessary medications and procedures.

(b) (1) No such policy that provides coverage for prescription drugs shall require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.

(2) Such policy may require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, a therapeutically equivalent generic drug, unless: (A) The brand name prescription drug contains United States Food and Drug Administration approved abuse-deterrent labeling, and (B) the therapeutically equivalent generic drug does not contain such labeling.

(c) As used in this section, "pain" means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and "pain management specialist" means a physician who is credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, physiatrist, neurologist, oncologist or radiation oncologist with additional training in pain management.

Sec. 2. Section 38a-518i of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):

(a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist that may include all means medically necessary to make a diagnosis and develop a treatment plan including the use of necessary medications and procedures.

(b) (1) No such policy that provides coverage for prescription drugs shall require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.

(2) Such policy may require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, a therapeutically equivalent generic drug, unless: (A) The brand name prescription drug contains United States Food and Drug Administration approved abuse-deterrent labeling, and (B) the therapeutically equivalent generic drug does not contain such labeling.

(c) As used in this section, "pain" means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and "pain management specialist" means a physician who is credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, physiatrist, neurologist, oncologist or radiation oncologist with additional training in pain management.

This act shall take effect as follows and shall amend the following sections:

Section 1

January 1, 2014

38a-492i

Sec. 2

January 1, 2014

38a-518i

GL

Joint Favorable

 
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