Connecticut Senate Bill SB00038

Connecticut 2019 Regular Session

• Introduced: 1/15/19
• Refer: 1/15/19
• Refer: 3/8/19
• Report Pass: 3/14/19
• Refer: 3/28/19
• Report Pass: 4/3/19

Caption

An Act Reducing The Time Frame For Urgent Care Adverse Determination Review Requests And Expedited External Reviews.

Impact

The implications of SB00038 on state laws are significant as it alters the statutory requirements for health insurance companies regarding timely decisions on urgent care requests. The bill delineates that in situations necessitating an expedited review, the health carrier must act more swiftly, which is expected to lead to improved access for patients needing urgent medical attention. By setting these stricter timeframes, the bill aligns the process with the urgency of healthcare needs, reinforcing patient rights in the face of potential delays that could affect treatment outcomes.

Summary

Bill SB00038, titled 'An Act Reducing the Time Frame for Urgent Care Adverse Determination Review Requests and Expedited External Reviews,' was introduced to modify existing timelines associated with health insurance reviews for urgent care requests. Specifically, the bill aims to decrease the time health carriers have to make determinations on urgent care requests, thereby expediting the review and notification process for patients who may require immediate healthcare services. According to the bill, health carriers must notify the granted or denied request within 24 hours instead of a longer period previously established.

Sentiment

General sentiment surrounding SB00038 has been largely supportive, especially among healthcare advocates who argue that reducing the timelines for adverse determination reviews can considerably enhance patient care and outcomes. Stakeholders such as patient advocacy groups laud the potential of the bill to ensure that individuals receive timely decisions, reducing the waiting period for critical healthcare services. However, some concerns have been raised about the capability of health carriers to meet the expedited timelines without compromising the thoroughness of their reviews.

Contention

Notable points of contention include the necessity and feasibility of imposing stricter review timelines on health carriers. Critics argue that while the aim is laudable, the implementation of tighter deadlines could potentially overwhelm healthcare providers and insurance companies, leading to rushed decisions that might not always be in the best interest of the patient. Furthermore, discussions around whether such legislative measures overstep and add undue regulation to the insurance landscape have also surfaced, indicating a divide in perspectives on how best to balance efficient patient care with regulatory oversight.