OLR Bill Analysis

sHB 5372 (as amended by House "A")*

AN ACT CONCERNING ACCESS TO IMAGING SERVICES.

SUMMARY:

This bill limits the copayments that can be imposed on a person for all magnetic resonance imaging (MRI), computed axial tomography (CAT scan), and positron emission tomography (PET scan) services performed in-network. It limits the copayments for MRIs and CAT scans to no more than (1) $ 375 for all such services annually and (2) $ 75 for each one. It limits the copayments for PET scans to no more than (1) $ 400 for all such scans annually and (2) $ 100 for each one.

These copayment limits apply provided the physician ordering the imaging service is not the same physician performing it or in the same practice group as him. The limits do not apply to high deductible health plans designed to be compatible with federally-qualified health savings accounts.

The bill applies to health insurers, HMOs, hospital service corporations, medical service corporations, and fraternal benefit societies providing group or individual coverage for such imaging services.

*House Amendment “A” replaces the original bill, which limited copayments for (1) in-network MRIs, CAT scans, and PET scans to $ 750 in any policy year and (2) any in-network PET scan to $ 200.

EFFECTIVE DATE: October 1, 2006

COMMITTEE ACTION

Insurance and Real Estate Committee

Joint Favorable Substitute