Bill Text: CT SB00018 | 2011 | General Assembly | Introduced
Bill Title: An Act Concerning Insurance Coverage For Breast Magnetic Resonance Imaging And Extending The Notification Period To Insurers Following The Birth Of A Child.
Spectrum: Moderate Partisan Bill (Democrat 24-6-1)
Status: (Passed) 2011-07-13 - Signed by the Governor [SB00018 Detail]
Download: Connecticut-2011-SB00018-Introduced.html
General Assembly |
Proposed Bill No. 18 |
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January Session, 2011 |
LCO No. 231 | ||||
Referred to Committee on Insurance and Real Estate |
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Introduced by: |
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SEN. LOONEY, 11th Dist. |
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AN ACT CONCERNING APPEALS OF HEALTH INSURANCE BENEFITS DENIALS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
That title 38a of the general statutes be amended to (1) specify a presumption of medical necessity for appeals reviewed by review entities on behalf of the Insurance Commissioner pursuant to section 38a-478n of the general statutes, (2) require managed care companies, health insurers and utilization review companies to provide to providers of record and enrollees after a final determination not to certify an admission, service, procedure or extension of stay, documents and information considered in such final determination, and (3) require dispensation and coverage of a prescribed drug for the duration of any appeal of a determination not to certify such dispensation.
Statement of Purpose:
To improve the quality of health care in this state by specifying a presumption of medical necessity for appeals of health insurance benefits denials, requiring documents and information that were considered in a final determination not to certify an admission, service, procedure or extension of stay to be provided to a provider of record and to an enrollee, and requiring dispensation and coverage of a prescribed drug during an appeal of a determination not to certify such dispensation.