Connecticut Seal

General Assembly

Amendment

 

January Session, 2011

LCO No. 5323

   
 

*SB0092305323SRO*

Offered by:

 

SEN. FASANO, 34th Dist.

 

To: Subst. Senate Bill No. 923

File No. 221

Cal. No. 165

After the last section, add the following and renumber sections and internal references accordingly:

"Sec. 501. (NEW) (Effective October 1, 2011) Each insurer, health care center, hospital service corporation, medical service corporation or fraternal benefit society that delivers, issues for delivery, renews, amends or continues an individual or group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes in this state, and contracts directly with a physician or physician group or physician organization to provide medical services under such policy shall, at such contracted physician's or physician's group's or physician's organization's request, establish a payment amount for the physician's professional services component of colonoscopy or endoscopic services covered under such policy, that is the same regardless of where the physician's professional services are performed. Such payment amount for the physician's professional services shall not be less than the amount that would otherwise be paid to such contracted physician or physician group or physician organization if the services are performed at a facility other than an outpatient surgical facility, as defined in section 19a-493b of the general statutes. Nothing in this section shall prohibit a contracted physician or physician group or physician organization from agreeing to a different payment methodology for colonoscopy or endoscopic services. "