CT
Connecticut House Bill HB06088

Connecticut 2019 Regular Session

Connecticut House Bill HB06088 Compare Versions

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7+General Assembly Substitute Bill No. 6088
8+January Session, 2019
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4-Substitute House Bill No. 6088
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6-Public Act No. 19-155
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9-AN ACT CONCERNING CO NTRACTING HEALTH
10-ORGANIZATIONS AND DE NTISTS, DENTAL PLANS AND
11-PROCEDURES.
12+AN ACT CONCERNING CO NTRACTING HEALTH ORG ANIZATIONS
13+AND DENTISTS, DENTAL PLANS AND PROCEDURES.
1214 Be it enacted by the Senate and House of Representatives in General
1315 Assembly convened:
1416
15-Section 1. Section 38a-479 of the general statutes is repealed and the
16-following is substituted in lieu thereof (Effective January 1, 2020):
17-(a) As used in this section and section 38a-479b, as amended by this
18-act:
19-(1) "Contracting health organization" means a managed care
20-organization, as defined in section 38a-478, or a preferred provider
21-network, as defined in section 38a-479aa.
22-(2) "Provider" means a physician, surgeon, chiropractor, podiatrist,
23-psychologist, optometrist, dentist, naturopath or advanced practice
24-registered nurse licensed in this state or a group or organization of
25-such individuals, who has entered into or renews a participating
26-provider contract with a contracting health organization to render
27-services to such organization's enrollees and enrollees' dependents.
28-(b) Each contracting health organization shall establish and
29-implement a procedure to provide to each provider: Substitute House Bill No. 6088
17+Section 1. Section 38a-479 of the general statutes is repealed and the 1
18+following is substituted in lieu thereof (Effective January 1, 2020): 2
19+(a) As used in this section and section 38a-479b, as amended by this 3
20+act: 4
21+(1) "Contracting health organization" means a managed care 5
22+organization, as defined in section 38a-478, or a preferred provider 6
23+network, as defined in section 38a-479aa. 7
24+(2) "Provider" means a physician, surgeon, chiropractor, podiatrist, 8
25+psychologist, optometrist, dentist, naturopath or advanced practice 9
26+registered nurse licensed in this state or a group or organization of 10
27+such individuals, who has entered into or renews a participating 11
28+provider contract with a contracting health organization to render 12
29+services to such organization's enrollees and enrollees' dependents. 13
30+(b) Each contracting health organization shall establish and 14
31+implement a procedure to provide to each provider: 15
32+(1) Access via the Internet or other electronic or digital format to the 16
33+contracting health organization's fees for (A) the current procedural 17
34+terminology (CPT) codes or current dental terminology (CDT) codes 18 Substitute Bill No. 6088
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33-(1) Access via the Internet or other electronic or digital format to the
34-contracting health organization's fees for (A) the current procedural
35-terminology (CPT) codes applicable to such provider's specialty or,
36-upon request, current dental terminology (CDT) codes, (B) the Health
37-Care Procedure Coding System (HCPCS) codes applicable to such
38-provider, and (C) such CPT codes, CDT codes and HCPCS codes as
39-may be requested by such provider for other services such provider
40-actually bills or intends to bill the contracting health organization,
41-provided such codes are within t he provider's specialty or
42-subspecialty; and
43-(2) Access via the Internet or other electronic or digital format to the
44-contracting health organization's policies and procedures regarding
45-(A) payments to providers, (B) providers' duties and requirements
46-under the participating provider contract, (C) inquiries and appeals
47-from providers, including contact information for the office or offices
48-responsible for responding to such inquiries or appeals and a
49-description of the rights of a provider, enrollee and enrollee's
50-dependents with respect to an appeal.
51-(c) The provisions of subdivision (1) of subsection (b) of this section
52-shall not apply to any provider whose services are reimbursed in a
53-manner that does not utilize current procedural terminology (CPT) or
54-current dental terminology (CDT) codes.
55-(d) The fee information received by a provider pursuant to
56-subdivision (1) of subsection (b) of this section is proprietary and shall
57-be confidential, and the procedure adopted pursuant to this section
58-may contain penalties for the unauthorized distribution of fee
59-information, which may include termination of the participating
60-provider contract.
61-Sec. 2. Section 38a-479b of the general statutes is repealed and the
62-following is substituted in lieu thereof (Effective January 1, 2020): Substitute House Bill No. 6088
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41+applicable to such provider's specialty, (B) the Health Care Procedure 19
42+Coding System (HCPCS) codes applicable to such provider, and (C) 20
43+such CPT codes, CDT codes and HCPCS codes as may be requested by 21
44+such provider for other services such provider actually bills or intends 22
45+to bill the contracting health organization, provided such codes are 23
46+within the provider's specialty or subspecialty; and 24
47+(2) Access via the Internet or other electronic or digital format to the 25
48+contracting health organization's policies and procedures regarding 26
49+(A) payments to providers, (B) providers' duties and requirements 27
50+under the participating provider contract, (C) inquiries and appeals 28
51+from providers, including contact information for the office or offices 29
52+responsible for responding to such inquiries or appeals and a 30
53+description of the rights of a provider, enrollee and enrollee's 31
54+dependents with respect to an appeal. 32
55+(c) The provisions of subdivision (1) of subsection (b) of this section 33
56+shall not apply to any provider whose services are reimbursed in a 34
57+manner that does not utilize current procedural terminology (CPT) or 35
58+current dental terminology (CDT) codes. 36
59+(d) The fee information received by a provider pursuant to 37
60+subdivision (1) of subsection (b) of this section is proprietary and shall 38
61+be confidential, and the procedure adopted pursuant to this section 39
62+may contain penalties for the unauthorized distribution of fee 40
63+information, which may include termination of the participating 41
64+provider contract. 42
65+Sec. 2. Section 38a-479b of the general statutes is repealed and the 43
66+following is substituted in lieu thereof (Effective January 1, 2020): 44
67+(a) No contracting health organization shall make material changes 45
68+to a provider's fee schedule except as follows: 46
69+(1) At one time annually, provided providers are given at least 47
70+ninety days' advance notice by mail, electronic mail or facsimile by 48
71+such organization of any such changes. With respect to a dental plan, 49 Substitute Bill No. 6088
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66-(a) No contracting health organization shall make material changes
67-to a provider's fee schedule except as follows:
68-(1) At one time annually, provided providers are given at least
69-ninety days' advance notice by mail, electronic mail or facsimile by
70-such organization of any such changes. Upon receipt of such notice, a
71-provider may terminate the participating provider contract with at
72-least sixty days' advance written notice to the contracting health
73-organization;
74-(2) At any time for the following, provided providers are given at
75-least thirty days' advance notice by mail, electronic mail or facsimile by
76-such organization of any such changes:
77-(A) To comply with requirements of federal or state law, regulation
78-or policy. If such federal or state law, regulation or policy takes effect
79-in less than thirty days, the organization shall give providers as much
80-notice as possible;
81-(B) To comply with changes to the medical data code sets set forth
82-in 45 CFR 162.1002, as amended from time to time;
83-(C) To comply with changes to national best practice protocols made
84-by the National Quality Forum or other national accrediting or
85-standard-setting organization based on peer-reviewed medical
86-literature generally recognized by the relevant medical community or
87-the results of clinical trials generally recognized and accepted by the
88-relevant medical community;
89-(D) To be consistent with changes made in Medicare pertaining to
90-billing or medical management practices, provided any such changes
91-are applied to relevant participating provider contracts where such
92-changes pertain to the same specialty or payment methodology;
93-(E) If a drug, treatment, procedure or device is identified as no Substitute House Bill No. 6088
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97-longer safe and effective by the federal Food and Drug Administration
98-or by peer-reviewed medical literature generally recognized by the
99-relevant medical community;
100-(F) To address payment or reimbursement for a new drug,
101-treatment, procedure or device that becomes available and is
102-determined to be safe and effective by the federal Food and Drug
103-Administration or by peer-reviewed medical literature generally
104-recognized by the relevant medical community; or
105-(G) As mutually agreed to by the contracting health organization
106-and the provider. If the contracting health organization and the
107-provider do not mutually agree, the provider's current fee schedule
108-shall remain in force until the annual change permitted pursuant to
109-subdivision (1) of this subsection.
110-(b) Notwithstanding subsection (a) of this section, a contracting
111-health organization may introduce a new insurance product to a
112-provider at any time, provided such provider is given at least sixty
113-days' advance notice by mail, electronic mail or facsimile by such
114-organization if the introduction of such insurance product will make
115-material changes to the provider's administrative requirements under
116-the participating provider contract or to the provider's fee schedule.
117-The provider may decline to participate in such new product by
118-providing notice to the contracting health organization as set forth in
119-the advance notice, which shall include a period of not less than thirty
120-days for a provider to decline, or in accordance with the time frames
121-under the applicable terms of such provider's participating provider
122-contract.
123-(c) (1) No contracting health organization shall cancel, deny or
124-demand the return of full or partial payment for an authorized covered
125-service due to administrative or eligibility error, more than eighteen
126-months after the date of the receipt of a clean claim, except if: Substitute House Bill No. 6088
78+such notice shall include the maximum allowable charge for each 50
79+dental procedure code. Upon receipt of such notice, a provider may 51
80+terminate the participating provider contract with at least sixty days' 52
81+advance written notice to the contracting health organization; 53
82+(2) At any time for the following, provided providers are given at 54
83+least thirty days' advance notice by mail, electronic mail or facsimile by 55
84+such organization of any such changes: 56
85+(A) To comply with requirements of federal or state law, regulation 57
86+or policy. If such federal or state law, regulation or policy takes effect 58
87+in less than thirty days, the organization shall give providers as much 59
88+notice as possible; 60
89+(B) To comply with changes to the medical data code sets set forth 61
90+in 45 CFR 162.1002, as amended from time to time; 62
91+(C) To comply with changes to national best practice protocols made 63
92+by the National Quality Forum or other national accrediting or 64
93+standard-setting organization based on peer-reviewed medical 65
94+literature generally recognized by the relevant medical community or 66
95+the results of clinical trials generally recognized and accepted by the 67
96+relevant medical community; 68
97+(D) To be consistent with changes made in Medicare pertaining to 69
98+billing or medical management practices, provided any such changes 70
99+are applied to relevant participating provider contracts where such 71
100+changes pertain to the same specialty or payment methodology; 72
101+(E) If a drug, treatment, procedure or device is identified as no 73
102+longer safe and effective by the federal Food and Drug Administration 74
103+or by peer-reviewed medical literature generally recognized by the 75
104+relevant medical community; 76
105+(F) To address payment or reimbursement for a new drug, 77
106+treatment, procedure or device that becomes available and is 78
107+determined to be safe and effective by the federal Food and Drug 79 Substitute Bill No. 6088
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129109
130-(A) Such organization has a documented basis to believe that such
131-claim was submitted fraudulently by such provider;
132-(B) The provider did not bill appropriately for such claim based on
133-the documentation or evidence of what medical service was actually
134-provided;
135-(C) Such organization has paid the provider for such claim more
136-than once;
137-(D) Such organization paid a claim that should have been or was
138-paid by a federal or state program; or
139-(E) The provider received payment for such claim from a different
140-insurer, payor or administrator through coordination of benefits or
141-subrogation, or due to coverage under an automobile insurance or
142-workers' compensation policy. Such provider shall have one year after
143-the date of the cancellation, denial or return of full or partial payment
144-to resubmit an adjusted secondary payor claim with such organization
145-on a secondary payor basis, regardless of such organization's timely
146-filing requirements.
147-(2) (A) Such organization shall give at least thirty days' advance
148-notice to a provider by mail, electronic mail or facsimile of the
149-organization's cancellation, denial or demand for the return of full or
150-partial payment pursuant to subdivision (1) of this subsection.
151-(B) If such organization demands the return of full or partial
152-payment from a provider, the notice required under subparagraph (A)
153-of this subdivision shall disclose to the provider (i) the amount that is
154-demanded to be returned, (ii) the claim that is the subject of such
155-demand, and (iii) the basis on which such return is being demanded.
156-(C) Not later than thirty days after the receipt of the notice required
157-under subparagraph (A) of this subdivision, a provider may appeal Substitute House Bill No. 6088
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114+Administration or by peer-reviewed medical literature generally 80
115+recognized by the relevant medical community; or 81
116+(G) As mutually agreed to by the contracting health organization 82
117+and the provider. If the contracting health organization and the 83
118+provider do not mutually agree, the provider's current fee schedule 84
119+shall remain in force until the annual change permitted pursuant to 85
120+subdivision (1) of this subsection. 86
121+(b) Notwithstanding subsection (a) of this section, a contracting 87
122+health organization may introduce a new insurance product to a 88
123+provider at any time, provided such provider is given at least sixty 89
124+days' advance notice by mail, electronic mail or facsimile by such 90
125+organization if the introduction of such insurance product will make 91
126+material changes to the provider's administrative requirements under 92
127+the participating provider contract or to the provider's fee schedule. 93
128+The provider may decline to participate in such new product by 94
129+providing notice to the contracting health organization as set forth in 95
130+the advance notice, which shall include a period of not less than thirty 96
131+days for a provider to decline, or in accordance with the time frames 97
132+under the applicable terms of such provider's participating provider 98
133+contract. 99
134+(c) (1) No contracting health organization shall cancel, deny or 100
135+demand the return of full or partial payment for an authorized covered 101
136+service due to administrative or eligibility error, more than eighteen 102
137+months after the date of the receipt of a clean claim, except if: 103
138+(A) Such organization has a documented basis to believe that such 104
139+claim was submitted fraudulently by such provider; 105
140+(B) The provider did not bill appropriately for such claim based on 106
141+the documentation or evidence of what medical service was actually 107
142+provided; 108
143+(C) Such organization has paid the provider for such claim more 109
144+than once; 110 Substitute Bill No. 6088
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161-such cancellation, denial or demand in accordance with the procedures
162-provided by such organization. Any demand for the return of full or
163-partial payment shall be stayed during the pendency of such appeal.
164-(D) If there is no appeal or an appeal is denied, such provider may
165-resubmit an adjusted claim, if applicable, to such organization, not
166-later than thirty days after the receipt of the notice required under
167-subparagraph (A) of this subdivision or the denial of the appeal,
168-whichever is applicable, except that if a return of payment was
169-demanded pursuant to subparagraph (C) of subdivision (1) of this
170-subsection, such claim shall not be resubmitted.
171-(E) A provider shall have one year after the date of the written
172-notice set forth in subparagraph (A) of this subdivision to identify any
173-other appropriate insurance coverage applicable on the date of service
174-and to file a claim with such insurer, health care center or other issuing
175-entity, regardless of such insurer's, health care center's or other issuing
176-entity's timely filing requirements.
177-(d) Except as provided in subsection (e) of this section, no
178-contracting health organization shall include in any participating
179-provider contract [, contract with a dentist] or contract with a hospital
180-licensed under chapter 368v, that is entered into, renewed or amended
181-on or after October 1, 2011, or contract offered to a provider [, dentist]
182-or hospital on or after October 1, 2011, any clause, covenant or
183-agreement that:
184-(1) Requires the provider [, dentist] or hospital to:
185-(A) Disclose to the contracting health organization the provider's [,
186-dentist's] or hospital's payment or reimbursement rates from any other
187-contracting health organization the provider [, dentist] or hospital has
188-contracted, or may contract, with;
189-(B) Provide services or procedures to the contracting health Substitute House Bill No. 6088
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193-organization at a payment or reimbursement rate equal to or lower
194-than the lowest of such rates the provider [, dentist] or hospital has
195-contracted, or may contract, with any other contracting health
196-organization;
197-(C) Certify to the contracting health organization that the provider [,
198-dentist] or hospital has not contracted with any other contracting
199-health organization to provide services or procedures at a payment or
200-reimbursement rate lower than the rates contracted for with the
201-contracting health organization;
202-(2) Prohibits or limits the provider [, dentist] or hospital from
203-contracting with any other contracting health organization to provide
204-services or procedures at a payment or reimbursement rate lower than
205-the rates contracted for with the contracting health organization; or
206-(3) Allows the contracting health organization to terminate or
207-renegotiate a contract with the provider [, dentist] or hospital prior to
208-renewal if the provider [, dentist] or hospital contracts with any other
209-contracting health organization to provide services or procedures at a
210-lower payment or reimbursement rate than the rates contracted for
211-with the contracting health organization.
212-(e) (1) If a contract described in subsection (d) of this section is in
213-effect prior to October 1, 2011, and includes a clause, covenant or
214-agreement set forth under subdivisions (1) to (3), inclusive, of said
215-subsection (d), such clause, covenant or agreement shall be void and
216-unenforceable on the date such contract is next renewed or on January
217-1, 2014, whichever is earlier. Such invalidity shall not affect other
218-provisions of such contract.
219-(2) Nothing in subdivision (1) of this subsection shall be construed
220-to affect the rights of a contracting health organization to enforce such
221-clause, covenant or agreement prior to the invalidation of such clause, Substitute House Bill No. 6088
151+(D) Such organization paid a claim that should have been or was 111
152+paid by a federal or state program; or 112
153+(E) The provider received payment for such claim from a different 113
154+insurer, payor or administrator through coordination of benefits or 114
155+subrogation, or due to coverage under an automobile insurance or 115
156+workers' compensation policy. Such provider shall have one year after 116
157+the date of the cancellation, denial or return of full or partial payment 117
158+to resubmit an adjusted secondary payor claim with such organization 118
159+on a secondary payor basis, regardless of such organization's timely 119
160+filing requirements. 120
161+(2) (A) Such organization shall give at least thirty days' advance 121
162+notice to a provider by mail, electronic mail or facsimile of the 122
163+organization's cancellation, denial or demand for the return of full or 123
164+partial payment pursuant to subdivision (1) of this subsection. 124
165+(B) If such organization demands the return of full or partial 125
166+payment from a provider, the notice required under subparagraph (A) 126
167+of this subdivision shall disclose to the provider (i) the amount that is 127
168+demanded to be returned, (ii) the claim that is the subject of such 128
169+demand, and (iii) the basis on which such return is being demanded. 129
170+(C) Not later than thirty days after the receipt of the notice required 130
171+under subparagraph (A) of this subdivision, a provider may appeal 131
172+such cancellation, denial or demand in accordance with the procedures 132
173+provided by such organization. Any demand for the return of full or 133
174+partial payment shall be stayed during the pendency of such appeal. 134
175+(D) If there is no appeal or an appeal is denied, such provider may 135
176+resubmit an adjusted claim, if applicable, to such organization, not 136
177+later than thirty days after the receipt of the notice required under 137
178+subparagraph (A) of this subdivision or the denial of the appeal, 138
179+whichever is applicable, except that if a return of payment was 139
180+demanded pursuant to subparagraph (C) of subdivision (1) of this 140
181+subsection, such claim shall not be resubmitted. 141 Substitute Bill No. 6088
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225-covenant or agreement.
226-Sec. 3. Section 38a-472c of the general statutes is repealed and the
227-following is substituted in lieu thereof (Effective January 1, 2020):
228-(a) For any policy delivered, issued for delivery, renewed, amended
229-or continued in this state that provides coverage for inpatient or
230-outpatient dental services only, the person who issues the policy shall
231-provide the insured or a licensed dentist acting on behalf of the
232-insured, upon request, an estimate of reimbursement under the policy
233-with respect to specific dental procedure codes ordered or
234-recommended for the insured by a licensed dentist, except that the
235-actual reimbursement may be adjusted based on factors such as the
236-insured's eligibility, plan design, utilization of benefits and the actual
237-claim submitted.
238-(b) No person that issues a policy described in subsection (a) of this
239-section that uses a provider network for such policy shall materially
240-adjust the fee schedule for in-network providers more than once
241-annually.
242-(c) Each person that makes a material adjustment described in
243-subsection (b) of this section shall issue a notice to each in-network
244-provider at least ninety days before the effective date of such
245-adjustment. Each such notice shall be sent by mail, electronic mail or
246-facsimile, and disclose:
247-(1) The percentage effect that such adjustment will have on such
248-provider's fees; or
249-(2) A measure, other than the measure described in subdivision (1)
250-of this subsection, that will enable such provider to understand how
251-such adjustment will affect such provider's fees for the twenty covered
252-procedures that such provider most frequently performed, and for
253-which such provider sought reimbursement, during the twelve months Substitute House Bill No. 6088
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188+(E) A provider shall have one year after the date of the written 142
189+notice set forth in subparagraph (A) of this subdivision to identify any 143
190+other appropriate insurance coverage applicable on the date of service 144
191+and to file a claim with such insurer, health care center or other issuing 145
192+entity, regardless of such insurer's, health care center's or other issuing 146
193+entity's timely filing requirements. 147
194+(d) Except as provided in subsection (e) of this section, no 148
195+contracting health organization shall include in any participating 149
196+provider contract [, contract with a dentist] or contract with a hospital 150
197+licensed under chapter 368v, that is entered into, renewed or amended 151
198+on or after October 1, 2011, or contract offered to a provider [, dentist] 152
199+or hospital on or after October 1, 2011, any clause, covenant or 153
200+agreement that: 154
201+(1) Requires the provider [, dentist] or hospital to: 155
202+(A) Disclose to the contracting health organization the provider's [, 156
203+dentist's] or hospital's payment or reimbursement rates from any other 157
204+contracting health organization the provider [, dentist] or hospital has 158
205+contracted, or may contract, with; 159
206+(B) Provide services or procedures to the contracting health 160
207+organization at a payment or reimbursement rate equal to or lower 161
208+than the lowest of such rates the provider [, dentist] or hospital has 162
209+contracted, or may contract, with any other contracting health 163
210+organization; 164
211+(C) Certify to the contracting health organization that the provider [, 165
212+dentist] or hospital has not contracted with any other contracting 166
213+health organization to provide services or procedures at a payment or 167
214+reimbursement rate lower than the rates contracted for with the 168
215+contracting health organization; 169
216+(2) Prohibits or limits the provider [, dentist] or hospital from 170
217+contracting with any other contracting health organization to provide 171
218+services or procedures at a payment or reimbursement rate lower than 172 Substitute Bill No. 6088
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225+the rates contracted for with the contracting health organization; or 173
226+(3) Allows the contracting health organization to terminate or 174
227+renegotiate a contract with the provider [, dentist] or hospital prior to 175
228+renewal if the provider [, dentist] or hospital contracts with any other 176
229+contracting health organization to provide services or procedures at a 177
230+lower payment or reimbursement rate than the rates contracted for 178
231+with the contracting health organization. 179
232+(e) (1) If a contract described in subsection (d) of this section is in 180
233+effect prior to October 1, 2011, and includes a clause, covenant or 181
234+agreement set forth under subdivisions (1) to (3), inclusive, of said 182
235+subsection (d), such clause, covenant or agreement shall be void and 183
236+unenforceable on the date such contract is next renewed or on January 184
237+1, 2014, whichever is earlier. Such invalidity shall not affect other 185
238+provisions of such contract. 186
239+(2) Nothing in subdivision (1) of this subsection shall be construed 187
240+to affect the rights of a contracting health organization to enforce such 188
241+clause, covenant or agreement prior to the invalidation of such clause, 189
242+covenant or agreement. 190
243+This act shall take effect as follows and shall amend the following
244+sections:
245+
246+Section 1 January 1, 2020 38a-479
247+Sec. 2 January 1, 2020 38a-479b
248+
249+Statement of Legislative Commissioners:
250+In Section 2(d), ", contract with a dentist", ", dentist" and ", dentist's"
251+were bracketed to conform with the changes being made in Section
252+1(a)(2).
253+
254+INS Joint Favorable Subst. -LCO
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