Researcher: JM Page 1 3/6/23
OLR Bill Analysis
HB 6550
AN ACT REQUIRING NOTICE OF DISCONTINUANCE OF
PRESCRIPTION MEDICATION UNDER A WORKERS'
COMPENSATION CLAIM.
SUMMARY
This bill requires an employer, or entities working on its behalf, to
give notice to an employee and the Workers’ Compensation
Commission (WCC) before discontinuing payments for prescription
medications the employee receives under workers’ compensation. The
bill sets requirements on how the notice must be made, gives the
employee a right to a hearing on the matter, and requires that payments
will not be discontinued or reduced before the administrative judge
approves in writing. (The bill’s provisions requiring this approval
appear to conflict with another part of the bill that states the notice must
say the discontinuance or reduction will take place automatically if the
employee does not request a hearing.)
The bill also provides for a penalty if payments are discontinued or
reduced without approval.
EFFECTIVE DATE: October 1, 2023
PRESCRIPTION DRUGS U NDER WORKERS’ COMPEN SATION
By law, when an employee is injured at work, the employer must
provide a physician, surgeon, physician assistant, or advanced practice
registered nurse (APRN) to attend to the injured employee. These
medical professionals can prescribe prescription drugs for the employee
as they deem reasonable or necessary and the employer or the
employer’s insurance (or any representative acting on behalf of the
employer or insurer) must pay for them.
Notice 2023HB-06550-R000008-BA.DOCX
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The bill requires the employer, or any insurer or other entity acting
on the employer’s behalf, to give notice of a possible discontinuance or
reduction of payments to be made by certified mail to the employee and
the WCC administrative law judge. The notice must inform the
employee that a request for a hearing must be made no later than 15
days after receiving the notice, or the change in payments will
automatically take effect. (The bill states a hearing can be requested only
for a discontinuance of payments. Presumably, even though other parts
of the bill address both a discontinuance or reduction of payments,
employees are not entitled to a hearing when benefits are only being
reduced, not discontinued.)
The notice also must include:
1. the reason for the discontinuance or reduction and the date it
would begin;
2. the employee’s identity, the employee’s attorney or other
representative, the employer, and the insurer;
3. information about the injury, including the date it happened, the
city or town where it happened, and its nature; and
4. medical documentation of the basis for the discontinuance or
reduction and the name of the claimant’s attending physician or
APRN.
The bill requires the notice to substantially follow a form included in
the bill, which requires a heading stating, “IMPORTANT,” followed by
the notification that the employer or insurer intends to reduce or
discontinue the person’s prescription payments on a set date and the
other required information above.
The form includes the following directions for the employee:
1. To request an Informal Hearing, call the Workers’ Compensation
Commission District Office in which your case is pending.
2. Be prepared to provide medical and other documentation to 2023HB-06550-R000008-BA.DOCX
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support your objection.
3. For your protection, note the date when you received this notice.
Hearing
Under the bill, after receiving the notice, the employee has 15 days to
request a hearing. The notice says the employee can call WCC to request
an informal hearing. These requests for a hearing must have priority
over requests for hearings on other matters.
An administrative law judge cannot approve a discontinuance or
reduction prior to the expiration of the 15-day period for requesting a
hearing or the completion of a hearing, whichever is later.
Penalty
Under the bill, when the administrative law judge finds the
employer, an insurer acting on its behalf, or an entity acting on behalf of
either the insurer or employer, has discontinued or reduced any
payments for prescriptions without the judge’s approval, they will be
required to pay to the employee (1) the amount of all payments
discontinued or reduced, plus interest at 1.25% per month or portion of
a month on any discontinued or reduced payments and (2) reasonable
attorney’s fees incurred by the employee related to the discontinuance
or reduction. (The bill potentially penalizes an entity acting on behalf of
an insurer for notice requirements that the bill does not impose on these
entities.)
COMMITTEE ACTION
Labor and Public Employees Committee
Joint Favorable
Yea 10 Nay 1 (02/16/2023)