HB07039: An Act Concerning The Return Of Health Care Provider Payments, Establishing A Working Group To Study Pharmacist Compensation For Administering Certain Services, Revising The Definition Of Clinical Peer And Concerning The Connecticut Unfair Insurance Practices Act.

Legislative Summary

To: (1) Prohibit health carriers from retroactively denying or recouping payment of health insurance claims paid to health care providers for mental health and substance use disorder benefits after two years from the date of service and when such health carrier fails to provide notice to such health care provider; (2) require that the Insurance Commissioner study insurance coverage requirements for health care services provided through telehealth to evaluate methods to ensure that residents of this state who are out of state for the purpose of attending an institution of higher learning receive such coverage for such services; (3) require that the Insurance Commissioner study dental provider reimbursement rate practices in this state as compared to other states to assess flexibility in reimbursement rate negotiations; (4) require that individual and group health insurance policies provide coverage for medical foods for individuals diagnosed with phenylketonuria; (5) require that individual and group health insurance policies (A) provide coverage for motorized wheelchairs and repairs to and replacement batteries for motorized wheelchairs, and (B) establish centralized locations for the collection of used motorized wheelchairs; (6) prohibit health carriers from recovering through health insurance premiums such health carriers' costs associated with lobbying or legislative action in this state; (7) require the Insurance Commissioner to study certain compensation practices for health care services provided by pharmacists licensed in this state; and (8) revise the definition of "clinical peer" with respect to utilization review of health care services and treatment.