LCO No. 1765 1 of 4 General Assembly Raised Bill No. 222 February Session, 2022 LCO No. 1765 Referred to Committee on LABOR AND PUBLIC EMPLOYEES Introduced by: (LAB) AN ACT REQUIRING NOTICE OF DISCONTINUING PRESCRIPTION MEDICINE UNDER A WORKERS' COMPENSATION CLAIM. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Subsection (a) of section 31-294d of the 2022 supplement to 1 the general statutes is repealed and the following is substituted in lieu 2 thereof (Effective October 1, 2022): 3 (a) (1) The employer, as soon as the employer has knowledge of an 4 injury, shall provide a competent physician, surgeon, physician 5 assistant or advanced practice registered nurse to attend the injured 6 employee and, in addition, shall furnish any medical and surgical aid or 7 hospital and nursing service, including medical rehabilitation services 8 and prescription drugs, as the physician, surgeon, physician assistant or 9 advanced practice registered nurse deems reasonable or necessary. The 10 employer, any insurer acting on behalf of the employer, or any other 11 entity acting on behalf of the employer or insurer shall be responsible 12 for paying the cost of such prescription drugs directly to the provider. 13 If the employer utilizes an approved providers list, when an employee 14 reports a work-related injury or condition to the employer the employer 15 Raised Bill No. 222 LCO No. 1765 2 of 4 shall provide the employee with such approved providers list within 16 two business days of such reporting. 17 (2) Before discontinuing payment for prescriptions which a physician 18 has deemed reasonable or necessary under this section, the employer, 19 or any insurer acting on behalf of the employer, shall notify the 20 commissioner and the employee, by certified mail, of the proposed 21 discontinuance of such payments. Such notice shall specify the reason 22 for the proposed discontinuance and the date such proposed 23 discontinuance or reduction will commence. The employer's or insurer's 24 notice of intention to discontinue payments shall (A) identify the 25 claimant, the claimant's attorney or other representative, the employer, 26 the insurer, and the injury, including the date of the injury, the city or 27 town in which the injury occurred and the nature of the injury, (B) 28 include medical documentation that (i) establishes the basis for the 29 discontinuance or reduction of payments, and (ii) identifies the 30 claimant's attending physician or advanced practice registered nurse, 31 and (C) be in substantially the following form: 32 IMPORTANT 33 STATE OF CONNECTICUT WORKERS' COMPENSATION 34 COMMISSION 35 YOU ARE HEREBY NOTIFIED THAT THE EMPL OYER OR 36 INSURER INTENDS TO REDUCE OR DISCONTINUE YOUR 37 PRESCRIPTION PAYMENTS ON .... (date) FOR THE FOLLOWING 38 REASONS: 39 If you object to the discontinuance of prescription payments as stated 40 in this notice, YOU MUST REQUEST A HEARING NOT LATER THAN 41 15 DAYS after your receipt of this notice, or this notice will 42 automatically be approved. 43 To request an Informal Hearing, call the Workers' Compensation 44 Commission District Office in which your case is pending. 45 Raised Bill No. 222 LCO No. 1765 3 of 4 Be prepared to provide medical and other documentation to support 46 your objection. For your protection, note the date when you received 47 this notice. 48 (3) No discontinuance or reduction shall become effective unless 49 specifically approved in writing by the commissioner. The employee 50 may request a hearing on any such proposed discontinuance not later 51 than fifteen days after receipt of such notice. Any such request for a 52 hearing shall be given priority over requests for hearings on other 53 matters. The commissioner shall not approve any such discontinuance 54 or reduction prior to the expiration of the period for requesting a 55 hearing or the completion of such hearing, whichever is later. 56 (4) In any case where the commissioner finds that an employer has 57 discontinued or reduced any payments made in accordance with this 58 section without the approval of the commissioner, such employer shall 59 be required to pay to the employee the total amount of all payments so 60 discontinued and shall be required to pay interest to the employee, at a 61 rate of one and one-quarter per cent per month or portion of a month, 62 on any payments so discontinued or on the total amount by which such 63 payments were reduced, as the case may be, plus reasonable attorney's 64 fees incurred by the employee in relation to such discontinuance or 65 reduction. 66 [(2)] (5) If the injured employee is a local or state police officer, state 67 marshal, judicial marshal, correction officer, emergency medical 68 technician, paramedic, ambulance driver, firefighter, or active member 69 of a volunteer fire company or fire department engaged in volunteer 70 duties, who has been exposed in the line of duty to blood or bodily fluids 71 that may carry blood-borne disease, the medical and surgical aid or 72 hospital and nursing service provided by the employer shall include any 73 relevant diagnostic and prophylactic procedure for and treatment of any 74 blood-borne disease. 75 This act shall take effect as follows and shall amend the following sections: Raised Bill No. 222 LCO No. 1765 4 of 4 Section 1 October 1, 2022 31-294d(a) Statement of Purpose: To require employers or insurers acting on behalf of employers to provide notice and get approval before discontinuing coverage for prescriptions. [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]