Connecticut Senate Bill SB00383

Connecticut 2018 Regular Session

• Introduced: 3/1/18
• Refer: 3/1/18

Caption

An Act Concerning Alternative Treatment Options.

Impact

The introduction of SB00383 is expected to significantly alter how health carriers operate within the state, as they will be compelled to maintain better networks or facilitate access to alternative providers when specific criteria are met. This legislation can lead to improved patient outcomes by ensuring that insured individuals are not limited by the availability of in-network providers. Furthermore, the bill aims to provide clear communication about grievance processes associated with adverse determinations, thereby enhancing transparency and accountability from health insurers.

Summary

SB00383, also known as the Act Concerning Alternative Treatment Options, is designed to enhance the rights of insured individuals by ensuring they receive necessary health care services from nonparticipating providers in specific circumstances. The bill mandates that health carriers create a process whereby covered individuals can obtain in-network benefits even when their insurer's network lacks the required specialty provider or when access involves unreasonable travel or delays. This provision aims to improve access to treatment options for patients requiring specialty care.

Contention

During discussions surrounding SB00383, notable points of contention arose regarding the balance between insurance company regulatory burdens and patient rights. Supporters of the bill argue that it will reduce obstacles for patients needing specialty care, while critics contend that it may impose excessive administrative burdens on health carriers. The challenge lies in finding a suitable equilibrium that safeguards patient interests without overextending the capabilities of insurance providers.