General Assembly Substitute Bill No. 6368
January Session, 2013 *_____HB06368HS____031313____*
General Assembly
Substitute Bill No. 6368
January Session, 2013
*_____HB06368HS____031313____*
AN ACT CONCERNING THE CHOICES HEALTH INSURANCE ASSISTANCE PROGRAM.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 17b-427 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(a) As used in this section:
(1) "CHOICES" means [Connecticut's programs for health insurance assistance, outreach, information and referral, counseling and eligibility screening;
(2) "CHOICES health insurance assistance program" means] (A) the Connecticut program for Health insurance assistance, Outreach, Information and referral, Counseling and Eligibility Screening; and (B) the federally recognized state health insurance assistance program funded pursuant to P.L. 101-508 and administered by the Department [of Social Services] on Aging, in conjunction with the area agencies on aging and the Center for Medicare Advocacy, that provides free information and assistance related to health insurance issues and concerns of older persons and other Medicare beneficiaries in Connecticut; and
[(3)] (2) "Medicare organization" means any corporate entity or other organization or group that contracts with the federal Centers for Medicare and Medicaid Services to provide health care services to Medicare beneficiaries in this state as an alternative to the traditional Medicare fee-for-service plan.
(b) The Department [of Social Services] on Aging shall administer [the CHOICES health insurance assistance program] CHOICES, which shall be a comprehensive Medicare advocacy program that provides assistance to Connecticut residents who are Medicare beneficiaries.
(c) The program shall [: (1) Maintain a toll-free telephone number to provide] provide: (1) Toll-free telephone access for consumers to obtain advice and information on Medicare benefits, including prescription drug benefits available through the Medicare Part D program, the Medicare appeals process, health insurance matters applicable to Medicare beneficiaries and long-term care options available in the state at least five days per week during normal business hours; (2) [provide] information, advice and representation, where appropriate, concerning the Medicare appeals process, by a qualified attorney or paralegal at least five days per week during normal business hours; (3) [prepare and distribute written materials to] information through appropriate means and format, including written materials, to Medicare beneficiaries, their families, senior citizens and organizations regarding Medicare benefits, including prescription drug benefits available through the Medicare Part D program and long-term care options available in the state; (4) [develop and distribute a Connecticut Medicare consumers guide, after consultation with the Insurance Commissioner and other organizations involved in servicing, representing or advocating for Medicare beneficiaries, which shall be available to any individual, upon request, and shall include: (A) Information permitting beneficiaries to compare their options for delivery of Medicare services; (B)] information concerning [the] Medicare plans [available to beneficiaries, including the traditional Medicare fee-for-service plan, Medicare Part D plans and the benefits and services available through each plan; (C)] and services, private insurance policies and federal and state-funded programs that are available to beneficiaries to supplement Medicare coverage; (5) information permitting Medicare beneficiaries to compare and evaluate their options for delivery of Medicare and supplemental insurance services; (6) information concerning the procedure to appeal a denial of care and the procedure to request an expedited appeal of a denial of care; [(D) information concerning private insurance policies and federal and state-funded programs that are available to supplement Medicare coverage for beneficiaries; (E) a worksheet for beneficiaries to use to evaluate the various plans, including Medicare Part D programs; and (F)] and (7) any other information the program or the Commissioner on Aging deems relevant to Medicare beneficiaries. [; (5) collaborate with other state agencies and entities in the development of consumer-oriented web sites that provide information on Medicare plans, including Medicare Part D plans, and long-term care options that are available in the state; and (6) include any functions the department deems necessary to conform to federal grant requirements.]
(d) The Commissioner on Aging may include any additional functions necessary to conform to federal grant requirements.
[(c)] (e) The Insurance Commissioner, in cooperation with, or on behalf of, the Commissioner [of Social Services] on Aging, may require each Medicare organization to: (1) Annually submit to the [commissioner] Insurance Commissioner any data, reports or information relevant to plan beneficiaries; and (2) at any other times at which changes occur, submit information to the [commissioner] Insurance Commissioner concerning current benefits, services or costs to plan beneficiaries. Such information may include information required under section 38a-478c.
[(d)] (f) Each Medicare organization that fails to file the annual data, reports or information requested pursuant to subsection [(c)] (e) of this section shall pay a late fee of one hundred dollars per day for each day from the due date of such data, reports or information to the date of filing. Each Medicare organization that files incomplete annual data, reports or information shall be so informed by the Insurance Commissioner, shall be given a date by which to remedy such incomplete filing and shall pay said late fee commencing from the new due date.
[(e)] (g) Not later than June 1, 2001, and annually thereafter, the Insurance Commissioner, in conjunction with the Healthcare Advocate, shall submit a list, in accordance with the provisions of section 11-4a, to the Governor and to the joint standing committees of the General Assembly having cognizance of matters relating to aging, human services and insurance, [and to the select committee of the General Assembly having cognizance of matters relating to aging, a list] of those Medicare organizations that have failed to file any data, reports or information requested pursuant to subsection [(c)] (e) of this section.
[(f)] (h) All hospitals, as defined in section 19a-490, which treat persons covered by Medicare Part A shall: (1) Notify incoming patients covered by Medicare of the availability of the services established pursuant to subsection [(b)] (c) of this section, (2) post or cause to be posted in a conspicuous place therein the toll-free number established pursuant to subsection [(b)] (c) of this section, and (3) provide each Medicare patient with the toll-free number and information on how to access the CHOICES program.
(i) The Commissioner on Aging may adopt regulations, in accordance with chapter 54, as necessary to implement the provisions of this section.
Sec. 2. Section 17b-367 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
The Office of Policy and Management, within existing budgetary resources and in consultation with the [Select Committee on Aging] joint standing committees of the General Assembly having cognizance of matters relating to aging and human services, the Commission on Aging, personnel designated by the Commissioner [of Social Services] on Aging who administer the CHOICES health insurance assistance program and the Long-Term Care Advisory Council, shall develop and maintain a single consumer-oriented Internet web site that provides comprehensive information on long-term care options that are available in Connecticut. The web site shall also include direct links and referral information regarding long-term care resources, including private and nonprofit organizations offering advice, counseling and legal services.
Sec. 3. Section 17b-429 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
The Commissioner [of Social Services] on Aging shall, within available appropriations, make information available to senior citizens and disabled persons concerning any pharmaceutical company's drug program for indigent persons by utilizing the ConnPACE program, the CHOICES health insurance assistance program, as [defined] described in section 17b-427, as amended by this act, and Infoline of Connecticut to deliver such information.
This act shall take effect as follows and shall amend the following sections:
Section 1 from passage 17b-427
Sec. 2 from passage 17b-367
Sec. 3 from passage 17b-429
This act shall take effect as follows and shall amend the following sections:
Section 1
from passage
17b-427
Sec. 2
from passage
17b-367
Sec. 3
from passage
17b-429
Statement of Legislative Commissioners:
In section 1(c)(3), "ensure access by" was deleted after "written materials, to"; in section 1(c)(7) "commissioner" was changed to "Commissioner on Aging" and in section 1(d) "department" was changed to "Commissioner on Aging" for clarity.
HS Joint Favorable Subst.
HS
Joint Favorable Subst.