General Assembly Committee Bill No. 5484
January Session, 2013 LCO No. 4385
*_____HB05484GL____031413____*
Referred to Committee on GENERAL LAW
Introduced by:
(GL)
General Assembly
Committee Bill No. 5484
January Session, 2013
LCO No. 4385
*_____HB05484GL____031413____*
Referred to Committee on GENERAL LAW
Introduced by:
(GL)
AN ACT CONCERNING HEALTH INSURANCE COVERAGE AND ABUSE-DETERRENT PRESCRIPTION MEDICATIONS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 38a-492i of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):
(a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist that may include all means medically necessary to make a diagnosis and develop a treatment plan including the use of necessary medications and procedures.
(b) (1) No such policy that provides coverage for prescription drugs shall require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.
(2) Such policy may require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, a therapeutically equivalent generic drug, unless: (A) The brand name prescription drug contains United States Food and Drug Administration approved abuse-deterrent labeling, and (B) the therapeutically equivalent generic drug does not contain such labeling.
(c) As used in this section, "pain" means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and "pain management specialist" means a physician who is credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, physiatrist, neurologist, oncologist or radiation oncologist with additional training in pain management.
Sec. 2. Section 38a-518i of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):
(a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist that may include all means medically necessary to make a diagnosis and develop a treatment plan including the use of necessary medications and procedures.
(b) (1) No such policy that provides coverage for prescription drugs shall require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, any alternative brand name prescription drugs or over-the-counter drugs.
(2) Such policy may require an insured to use, prior to using a brand name prescription drug prescribed by a licensed physician for pain treatment, a therapeutically equivalent generic drug, unless: (A) The brand name prescription drug contains United States Food and Drug Administration approved abuse-deterrent labeling, and (B) the therapeutically equivalent generic drug does not contain such labeling.
(c) As used in this section, "pain" means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and "pain management specialist" means a physician who is credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, physiatrist, neurologist, oncologist or radiation oncologist with additional training in pain management.
This act shall take effect as follows and shall amend the following sections:
Section 1 January 1, 2014 38a-492i
Sec. 2 January 1, 2014 38a-518i
This act shall take effect as follows and shall amend the following sections:
Section 1
January 1, 2014
38a-492i
Sec. 2
January 1, 2014
38a-518i
GL Joint Favorable
GL
Joint Favorable