Connecticut 2019 Regular Session

Connecticut House Bill HB06095 Compare Versions

Version 1 (Old)

Version 2 (New)

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7	6		General Assembly Committee Bill No. 6095
8	7		January Session, 2019
9	8		LCO No. 5488
10	9
11	10
12	11		Referred to Committee on INSURANCE AND REAL ESTATE
13	12
14	13
15	14		Introduced by:
16	15		(INS)
17	16
18	17
19	18
20	19		AN ACT CONCERNING RE QUIRED HEALTH INSURANCE
21	20		COVERAGE FOR DETOXIF ICATION AND SUBSTANC E ABUSE
22	21		SERVICES.
23	22		Be it enacted by the Senate and House of Representatives in General
24	23		Assembly convened:
25	24
26	25		Section 1. Section 38a-492p of the general statutes is repealed and 1
27	26		the following is substituted in lieu thereof (Effective January 1, 2020): 2
28	27		Each insurance company, hospital service corporation, medical 3
29	28		service corporation, health care center, fraternal benefit society or other 4
30	29		entity that delivers, issues for delivery, renews, amends or continues in 5
31	30		this state an individual health insurance policy providing coverage of 6
32	31		the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-7
33	32		469 that provides coverage to an insured or enrollee who has been 8
34	33		diagnosed with a substance use disorder, as described in section 17a-9
35	34		458, shall cover: [medically necessary, medically monitored inpatient 10
36	35		detoxification services and medically necessary, medically managed 11
37	36		intensive inpatient detoxification services provided to the insured or 12
38	37		enrollee. For purposes of this section, "medically monitored inpatient 13
39	38		detoxification" and "medically managed intensive inpatient 14
40		-	detoxification" have the same meanings as described in the most recent 15 Committee Bill No. 6095
	39	+	detoxification" have the same meanings as described in the most recent 15
	40	+	Committee Bill No. 6095
41	41
42	42
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47	45		edition of the American Society of Addiction Medicine Treatment 16
48	46		Criteria for Addictive, Substance-Related and Co-Occurring 17
49	47		Conditions] 18
50	48		(1) Family counseling and intervention services for the insured or 19
51	49		enrollee; 20
52	50		(2) Not more than seven days of inpatient hospital or nonhospital 21
53	51		detoxification services per admission for the insured or enrollee; and 22
54	52		(3) Not fewer than: 23
55	53		(A) Four admissions for inpatient hospital or nonhospital 24
56	54		detoxification services for the insured or enrollee during such insured's 25
57	55		or enrollee's lifetime; 26
58	56		(B) Thirty days of substance abuse services rendered to the insured 27
59	57		or enrollee at a residential treatment facility during any year; 28
60	58		(C) Ninety days of substance abuse services rendered to the insured 29
61	59		or enrollee at a residential treatment facility during such insured's or 30
62	60		enrollee's lifetime; 31
63	61		(D) Thirty sessions of outpatient or partial hospitalization substance 32
64	62		abuse services for the insured or enrollee during any year; 33
65	63		(E) One hundred twenty sessions of outpatient or partial 34
66	64		hospitalization substance abuse services for the insured or enrollee 35
67	65		during such insured's or enrollee's lifetime; and 36
68	66		(F) Thirty additional sessions of outpatient or partial hospitalization 37
69	67		substance abuse services for the insured or enrollee during such 38
70	68		insured's or enrollee's lifetime, which such insured or enrollee may 39
71	69		exchange on a two-to-one basis to obtain fifteen additional days of 40
72	70		nonhospital substance abuse services rendered to such insured or 41
73	71		enrollee at a residential treatment facility during such insured's or 42
74		-	enrollee's lifetime. 43 Committee Bill No. 6095
	72	+	enrollee's lifetime. 43
	73	+	Committee Bill No. 6095
75	74
76	75
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81	78		Sec. 2. Section 38a-518p of the general statutes is repealed and the 44
82	79		following is substituted in lieu thereof (Effective January 1, 2020): 45
83	80		Each insurance company, hospital service corporation, medical 46
84	81		service corporation, health care center, fraternal benefit society or other 47
85	82		entity that delivers, issues for delivery, renews, amends or continues in 48
86	83		this state a group health insurance policy providing coverage of the 49
87	84		type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 50
88	85		that provides coverage to an insured or enrollee who has been 51
89	86		diagnosed with a substance use disorder, as described in section 17a-52
90	87		458, shall cover: [medically necessary, medically monitored inpatient 53
91	88		detoxification services and medically necessary, medically managed 54
92	89		intensive inpatient detoxification services provided to the insured or 55
93	90		enrollee. For purposes of this section, "medically monitored inpatient 56
94	91		detoxification" and "medically managed intensive inpatient 57
95	92		detoxification" have the same meanings as described in the most recent 58
96	93		edition of the American Society of Addiction Medicine Treatment 59
97	94		Criteria for Addictive, Substance-Related and Co-Occurring 60
98	95		Conditions] 61
99	96		(1) Family counseling and intervention services for the insured or 62
100	97		enrollee; 63
101	98		(2) Not more than seven days of inpatient hospital or nonhospital 64
102	99		detoxification services per admission for the insured or enrollee; and 65
103	100		(3) Not fewer than: 66
104	101		(A) Four admissions for inpatient hospital or nonhospital 67
105	102		detoxification services for the insured or enrollee during such insured's 68
106	103		or enrollee's lifetime; 69
107	104		(B) Thirty days of substance abuse services rendered to the insured 70
108	105		or enrollee at a residential treatment facility during any year; 71
109	106		(C) Ninety days of substance abuse services rendered to the insured 72
110		-	or enrollee at a residential treatment facility during such insured's or 73 Committee Bill No. 6095
	107	+	or enrollee at a residential treatment facility during such insured's or 73
	108	+	Committee Bill No. 6095
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117	113		enrollee's lifetime; 74
118	114		(D) Thirty sessions of outpatient or partial hospitalization substance 75
119	115		abuse services for the insured or enrollee during any year; 76
120	116		(E) One hundred twenty sessions of outpatient or partial 77
121	117		hospitalization substance abuse services for the insured or enrollee 78
122	118		during such insured's or enrollee's lifetime; and 79
123	119		(F) Thirty additional sessions of outpatient or partial hospitalization 80
124	120		substance abuse services for the insured or enrollee during such 81
125	121		insured's or enrollee's lifetime, which such insured or enrollee may 82
126	122		exchange on a two-to-one basis to obtain fifteen additional days of 83
127	123		nonhospital substance abuse services rendered to such insured or 84
128	124		enrollee at a residential treatment facility during such insured's or 85
129	125		enrollee's lifetime. 86
130	126		This act shall take effect as follows and shall amend the following
131	127		sections:
132	128
133	129		Section 1 January 1, 2020 38a-492p
134	130		Sec. 2 January 1, 2020 38a-518p
135	131
136		-	INS Joint Favorable
	132	+	Statement of Purpose:
	133	+	To modify required health insurance coverage for detoxification and
	134	+	substance abuse services.
	135	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
	136	+	except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
	137	+	not underlined.]
	138	+
	139	+	Co-Sponsors: REP. PERILLO, 113th Dist.; REP. HAMPTON, 16th Dist.
	140	+
	141	+	H.B. 6095
	142	+
137	143