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General Assembly Substitute Bill No. 6397
January Session, 2021
AN ACT EXPANDING THE DEFINITION OF A REPORTING ENTITY TO
THE ALL-PAYER CLAIMS DATABASE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subparagraph (A) of subdivision (2) of subsection (a) of 1
section 19a-755a of the general statutes is repealed and the following is 2
substituted in lieu thereof (Effective October 1, 2021): 3
(2) (A) "Reporting entity" means: 4
(i) An insurer, as described in section 38a-1, licensed to do health 5
insurance business in this state; 6
(ii) A health care center, as defined in section 38a-175; 7
(iii) An insurer or health care center that provides coverage under 8
Part C or Part D of Title XVIII of the Social Security Act, as amended 9
from time to time, to residents of this state; 10
(iv) A third-party administrator, as defined in section 38a-720; 11
(v) A pharmacy benefits manager, as defined in section 38a-479aaa; 12
(vi) A hospital service corporation, as defined in section 38a-199; 13
(vii) A nonprofit medical service corporation, as defined in section 14 Substitute Bill No. 6397
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38a-214; 15
(viii) A fraternal benefit society, as described in section 38a-595, that 16
transacts health insurance business in this state; 17
(ix) A dental plan organization, as defined in section 38a-577; 18
(x) A preferred provider network, as defined in section 38a-479aa; 19
[and] 20
(xi) An entity that pays claims received by the entity, or an insurer 21
acting on the entity's behalf, for treatment of any injury or illness under 22
a medical care plan approved by the chairman of the Workers' 23
Compensation Commission pursuant to chapter 568; and 24
[(xi)] (xii) Any other person that administers health care claims and 25
payments pursuant to a contract or agreement or is required by statute 26
to administer such claims and payments. 27
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2021 19a-755a(a)(2)(A)
Statement of Legislative Commissioners:
In Section 1(2)(A)(xi), "medical plan" was changed to "medical care plan"
for accuracy.
PH Joint Favorable Subst. -LCO