Raised S.B. No. 1045
Session Year 2021


AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION AND UTILIZATION REVIEWS, AND HEALTH INSURANCE COVERAGE FOR CHILDREN, STEPCHILDREN AND OTHER DEPENDENT CHILDREN.

To: (1) Allow a child, stepchild or other dependent child to retain health insurance coverage under a parent's individual or group health insurance policy until the policy anniversary date after the date on which the child, stepchild or other dependent child attains the age of twenty-six; (2) prohibit certain health carriers from requiring the use of step therapy for drugs prescribed to treat behavioral health conditions or chronic, disabling or life-threatening conditions or diseases; (3) redefine "clinical peer" for the purposes of adverse determination and utilization reviews; (4) require health carriers to bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; and (5) require health carriers to provide certain clinical peers with the authority to reverse initial adverse determinations.


Other Bills with Similar Topics

  Dependents 

  Drugs 

 

  Health insurance 

 

  Stepchildren 

  Utilization review 

  Health insurance claims denials