General Assembly Governor's Bill No. 6392
January Session, 2011 LCO No. 3446
*03446__________*
Referred to Committee on Public Health
Introduced by:
REP. DONOVAN, 84th Dist. REP. SHARKEY, 88th Dist. SEN. WILLIAMS, 29th Dist. SEN. LOONEY, 11th Dist.
General Assembly
Governor's Bill No. 6392
January Session, 2011
LCO No. 3446
*03446__________*
Referred to Committee on Public Health
Introduced by:
REP. DONOVAN, 84th Dist.
REP. SHARKEY, 88th Dist.
SEN. WILLIAMS, 29th Dist.
SEN. LOONEY, 11th Dist.
AN ACT CONCERNING BIRTH-TO-THREE SERVICES AND REHABILITATION SERVICES FOR CHRONIC GAMBLERS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 38a-490a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery or renewed in this state on or after July 1, 1996, shall provide coverage for medically necessary early intervention services provided as part of an individualized family service plan pursuant to section 17a-248e. Such policy shall provide [(1)] coverage for such services provided by qualified personnel, as defined in section 17a-248, for a child from birth until the child's third birthday. [, and (2)] No such policy shall impose a coinsurance, copayment, deductible or other out-of-pocket expense for such services that are more restrictive than that imposed on substantially all other benefits provided under such policy, except that a high deductible plan, as that term is used in subsection (f) of section 38a-493, shall not be subject to the deductible limits set forth in this section. Such policy shall provide a maximum benefit of six thousand four hundred dollars per child per year and an aggregate benefit of nineteen thousand two hundred dollars per child over the total three-year period, except that for a child with autism spectrum disorders, as defined in section 38a-514b, as amended by this act, the maximum benefit shall be fifty thousand dollars per child per year and an aggregate benefit of one hundred fifty thousand dollars per child over the total three-year period. No payment made under this section shall be applied by the insurer, health care center or plan administrator against any maximum lifetime or annual limits specified in the policy or health benefits plan.
Sec. 2. Section 38a-516a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery or renewed in this state on or after July 1, 1996, shall provide coverage for medically necessary early intervention services provided as part of an individualized family service plan pursuant to section 17a-248e. Such policy shall provide [(1)] coverage for such services provided by qualified personnel, as defined in section 17a-248, for a child from birth until the child's third birthday. [, and (2)] No such policy shall impose a coinsurance, copayment, deductible or other out-of-pocket expense for such services that are more restrictive than that imposed on substantially all other benefits provided under such policy, except that a high deductible plan, as that term is used in subsection (f) of section 38a-493, shall not be subject to the deductible limits set forth in this section. Such policy shall provide a maximum benefit of six thousand four hundred dollars per child per year and an aggregate benefit of nineteen thousand two hundred dollars per child over the total three-year period, except that for a child with autism spectrum disorders, as defined in section 38a-514b, as amended by this act, the maximum benefit shall be fifty thousand dollars per child per year and an aggregate benefit of one hundred fifty thousand dollars per child over the total three-year period. No payment made under this section shall be applied by the insurer, health care center or plan administrator against any maximum lifetime or annual limits specified in the policy or health benefits plan.
Sec. 3. Section 12-818 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
For each of the fiscal years ending June 30, 2010, and June 30, 2011, the Connecticut Lottery Corporation shall transfer one million nine hundred thousand dollars of the revenue received from the sale of lottery tickets to the chronic gamblers treatment rehabilitation account created pursuant to section 17a-713. For the fiscal year ending June 30, 2012, and each fiscal year thereafter, the Connecticut Lottery Corporation shall transfer one million [five] nine hundred thousand dollars of the revenue received from the sale of lottery tickets to the chronic gamblers treatment rehabilitation account created pursuant to section 17a-713.
Sec. 4. Section 38a-488b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 that is delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2009, shall provide coverage for physical therapy, speech therapy and occupational therapy services for the treatment of autism spectrum disorders, as set forth in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders", to the extent such services are a covered benefit for other diseases and conditions under such policy. Coverage for any child under the age of three shall be in conformity with the provisions of this section and section 38a-490a, as amended by this act.
Sec. 5. Subsection (e) of section 38a-514b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
(e) Such policy shall not impose (1) any limits on the number of visits an insured may make to an autism services provider pursuant to a treatment plan on any basis other than a lack of medical necessity, or (2) a coinsurance, copayment, deductible or other out-of-pocket expense for such coverage that places a greater financial burden on an insured for access to the diagnosis and treatment of an autism spectrum disorder than for the diagnosis and treatment of any other medical, surgical or physical health condition under such policy. Notwithstanding the provisions of this subsection, coverage for any child under the age of three shall be in conformity with the provisions of section 38a-516a, as amended by this act.
This act shall take effect as follows and shall amend the following sections:
Section 1 July 1, 2011 38a-490a
Sec. 2 July 1, 2011 38a-516a
Sec. 3 July 1, 2011 12-818
Sec. 4 July 1, 2011 38a-488b
Sec. 5 July 1, 2011 38a-514b(e)
This act shall take effect as follows and shall amend the following sections:
Section 1
July 1, 2011
38a-490a
Sec. 2
July 1, 2011
38a-516a
Sec. 3
July 1, 2011
12-818
Sec. 4
July 1, 2011
38a-488b
Sec. 5
July 1, 2011
38a-514b(e)
Statement of Purpose:
To implement the Governor's budget recommendations.
[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.]