Bill Text: CT SB01083 | 2011 | General Assembly | Introduced
Bill Title: An Act Concerning Health Insurance Coverage Of Prescription Drugs For Pain Treatment.
Spectrum: Moderate Partisan Bill (Democrat 8-1-1)
Status: (Passed) 2011-07-13 - Signed by the Governor [SB01083 Detail]
Download: Connecticut-2011-SB01083-Introduced.html
General Assembly |
Raised Bill No. 1083 | ||
January Session, 2011 |
LCO No. 3517 | ||
*03517_______INS* | |||
Referred to Committee on Insurance and Real Estate |
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Introduced by: |
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(INS) |
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AN ACT CONCERNING HEALTH INSURANCE COVERAGE OF PRESCRIPTION DRUGS FOR PAIN TREATMENT.
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 Section 38a-492i of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2012):
(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 [on or after January 1, 2001,] shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist [which] 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.
(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, 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 Section 38a-518i of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2012):
(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 [on or after January 1, 2001,] shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist [which] 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.
(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, 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, 2012 |
38a-492i |
Sec. 2 |
January 1, 2012 |
38a-518i |
Statement of Purpose:
To prohibit individual and group health insurance policies that provide coverage for prescription drugs from requiring insureds 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.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]