AN ACT CONCERNING HEALTH INSURANCE AND PATIENT PROTECTION.
To: (1) Establish (A) certain reporting requirements and enforcement provisions concerning compliance with mental health and substance use disorder benefit laws, and (B) the parity advancement account; (2) require health carriers to bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; (3) establish certain prohibitions on the use of step therapy for prescription drugs; (4) require health carriers to include certain provisions in contracts with health care providers regarding reimbursement for certain covered health benefits; (5) establish certain requirements concerning stop loss insurance policies for health care or medical benefits under any self-funded employee health benefit plan; (6) establish certain health insurance rate filing requirements and require that the Insurance Commissioner adopt regulations concerning affordability in rate filing; (7) prohibit the use of artificial intelligence to make an adverse determination based on medical necessity; and (8) prohibit any individual or group health insurance policy from imposing (A) arbitrary time limits on reimbursement for general anesthesia services, or (B) unilateral arbitrary limitations on reimbursement for medically necessary ancillary services.
Introduced by:
Insurance and Real Estate Committee
