Connecticut Seal

General Assembly

 

Committee Bill No. 6433

January Session, 2017

 

LCO No. 4457

 

*04457HB06433INS*

Referred to Committee on INSURANCE AND REAL ESTATE

 

Introduced by:

 

(INS)

 

AN ACT CONCERNING CLINICAL PEER REVIEW PERFORMED FOR PURPOSES OF A UTILIZATION REVIEW.

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

Section 1. Subdivision (7) of section 38a-591a of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2018):

(7) "Clinical peer" means a physician or other health care professional who (A) holds a nonrestricted license in [a] this state [of the United States and] in the same [or similar] specialty as typically manages the medical condition, procedure or treatment under review, and (B) for a review specified under subparagraph (B) or (C) of subdivision (38) of this section concerning (i) a child or adolescent substance use disorder or a child or adolescent mental disorder, holds (I) a national board certification in child and adolescent psychiatry, or (II) a doctoral level psychology degree with training and clinical experience in the treatment of child and adolescent substance use disorder or child and adolescent mental disorder, as applicable, or (ii) an adult substance use disorder or an adult mental disorder, holds (I) a national board certification in psychiatry, or (II) a doctoral level psychology degree with training and clinical experience in the treatment of adult substance use disorders or adult mental disorders, as applicable.

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

Section 1

January 1, 2018

38a-591a(7)

Statement of Purpose:

To require that a clinical peer who performs a clinical peer review during a utilization review be licensed in this state in the same specialty as typically manages the medical condition, procedure or treatment under review.

[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.]

Co-Sponsors:

REP. FOX, 148th Dist.

H.B. 6433