LCO No. 671 1 of 2
General Assembly Proposed Bill No. 202
January Session, 2021
LCO No. 671
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
SEN. LOONEY, 11th Dist.
AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION
AND UTILIZATION REVIEWS, AND REQUIRED HEALTH INSURANCE
COVERAGE FOR CHILDREN, STEPCHILDREN AND OTHER
DEPENDENT CHILDREN.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
That title 38a of the general statutes be amended to: (1) Prohibit health 1
carriers from requiring the use of step therapy for drugs prescribed to 2
treat disabling, chronic or life-threatening diseases or conditions; (2) 3
require that health carriers bear the burden of proving that certain 4
health care services under adverse determination or utilization review 5
are not medically necessary; (3) redefine "clinical peer" for the purposes 6
of adverse determination and utilization reviews; (4) require health 7
carriers to provide certain clinical peers with the authority to reverse 8
initial adverse determinations; and (5) allow children, stepchildren and 9
other dependent children to retain health insurance coverage under 10
their parents' insurance policies until the end of the policy year during 11
which they attain the age of twenty-six. 12 Proposed Bill No. 202
LCO No. 671 2 of 2
Statement of Purpose:
To: (1) Prohibit health carriers from requiring the use of step therapy for
drugs prescribed to treat disabling, chronic or life-threatening diseases
or conditions; (2) require that health carriers bear the burden of proving
that certain health care services under adverse determination or
utilization review are not medically necessary; (3) redefine "clinical
peer" for the purposes of adverse determination and utilization reviews;
(4) require health carriers to provide certain clinical peers with the
authority to reverse initial adverse determinations; and (5) allow
children, stepchildren and other dependent children to retain health
insurance coverage under their parents' insurance policies until the end
of the policy year during which they attain the age of twenty-six.