CT
Connecticut House Bill HB06550

Connecticut 2023 Regular Session

Connecticut House Bill HB06550 Compare Versions

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75 General Assembly Raised Bill No. 6550
86 January Session, 2023
97 LCO No. 3255
108
119
12-Referred to Committee on LABOR AND PUBLIC
13-EMPLOYEES
10+Referred to Committee on LABOR AND PUBLIC EMPLOYEES
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1613 Introduced by:
1714 (LAB)
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1816
1917
2018
2119 AN ACT REQUIRING NOTICE OF DISCONTINUANCE OF
2220 PRESCRIPTION MEDICATION UNDER A WORKERS'
2321 COMPENSATION CLAIM.
2422 Be it enacted by the Senate and House of Representatives in General
2523 Assembly convened:
2624
2725 Section 1. Subsection (a) of section 31-294d of the general statutes is 1
28-repealed and the following is substituted in lieu thereof (Effective 2
29-October 1, 2023): 3
26+repealed and the following is substituted in lieu thereof (Effective October 2
27+1, 2023): 3
3028 (a) (1) The employer, as soon as the employer has knowledge of an 4
3129 injury, shall provide a competent physician, surgeon, physician 5
3230 assistant or advanced practice registered nurse to attend to the injured 6
33-employee and, in addition, shall furnish any medical and surgical aid 7
34-or hospital and nursing service, including medical rehabilitation 8
35-services and prescription drugs, as the physician, surgeon, physician 9
36-assistant or advanced practice registered nurse deems reasonable or 10
37-necessary. The employer, any insurer acting on behalf of the employer, 11
38-or any other entity acting on behalf of the employer or insurer shall be 12
39-responsible for paying the cost of such prescription drugs directly to 13
40-the provider. If the employer utilizes an approved providers list, when 14 Raised Bill No. 6550
31+employee and, in addition, shall furnish any medical and surgical aid or 7
32+hospital and nursing service, including medical rehabilitation services 8
33+and prescription drugs, as the physician, surgeon, physician assistant or 9
34+advanced practice registered nurse deems reasonable or necessary. The 10
35+employer, any insurer acting on behalf of the employer, or any other 11
36+entity acting on behalf of the employer or insurer shall be responsible 12
37+for paying the cost of such prescription drugs directly to the provider. 13
38+If the employer utilizes an approved providers list, when an employee 14 Raised Bill No. 6550
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47-an employee reports a work-related injury or condition to the 15
48-employer the employer shall provide the employee with such 16
49-approved providers list within two business days of such reporting. 17
42+LCO No. 3255 2 of 4
43+
44+reports a work-related injury or condition to the employer the employer 15
45+shall provide the employee with such approved providers list within 16
46+two business days of such reporting. 17
5047 (2) If an employer, any insurer acting on behalf of the employer or 18
5148 any other entity acting on behalf of the employer proposes 19
5249 discontinuing or reducing payment for any prescription drug, that a 20
5350 physician, surgeon, physician assistant or advanced practice registered 21
5451 nurse has deemed reasonable or necessary under this section, such 22
5552 employer, insurer or other entity shall notify the administrative law 23
5653 judge and the employee, by certified mail, of such proposed 24
5754 discontinuance or reduction of such payments. Such notice shall: 25
5855 (A) Specify the reason for the proposed discontinuance or reduction 26
59-and the date such proposed discontinuance or reduction will take 27
60-effect; 28
61-(B) Identify the employee, the employee's attorney or other 29
62-representative, the employer, the insurer, and the injury, including the 30
63-date of the injury, the city or town in which the injury occurred and the 31
64-nature of the injury; 32
65-(C) Include any medical documentation that (i) establishes the basis 33
66-for the discontinuance or reduction of payments, and (ii) identifies the 34
67-employee's attending physician or advanced practice registered nurse; 35
68-and 36
69-(D) Be in substantially the following form: 37
70-"IMPORTANT 38
71-STATE OF CONNECTICUT WORKERS' COMPENSATION 39
72-COMMISSION 40
73-YOU ARE HEREBY NOTIFIED THAT THE EMPLOYER OR 41
74-INSURER INTENDS TO REDUCE OR DISCONTINUE YOUR 42
75-PRESCRIPTION PAYMENTS ON .... (date) FOR THE FOLLOWING 43 Raised Bill No. 6550
56+and the date such proposed discontinuance or reduction will take effect; 27
57+(B) Identify the employee, the employee's attorney or other 28
58+representative, the employer, the insurer, and the injury, including the 29
59+date of the injury, the city or town in which the injury occurred and the 30
60+nature of the injury; 31
61+(C) Include any medical documentation that (i) establishes the basis 32
62+for the discontinuance or reduction of payments, and (ii) identifies the 33
63+employee's attending physician or advanced practice registered nurse; 34
64+and 35
65+(D) Be in substantially the following form: 36
66+"IMPORTANT 37
67+STATE OF CONNECTICUT WORKERS' COMPENSATION 38
68+COMMISSION 39
69+YOU ARE HEREBY NOTIFIED THAT THE EMPLOYER OR 40
70+INSURER INTENDS TO REDUCE OR DISCONTINUE YOUR 41
71+PRESCRIPTION PAYMENTS ON .... (date) FOR THE FOLLOWING 42
72+REASONS: 43 Raised Bill No. 6550
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82-REASONS: 44
83-If you object to the discontinuance of prescription payments as 45
84-stated in this notice, YOU MUST REQUEST A HEARING NOT LATER 46
85-THAN 15 DAYS after your receipt of this notice, or this notice will 47
86-automatically take effect. 48
87-To request an Informal Hearing, call the Workers' Compensation 49
88-Commission District Office in which your case is pending. 50
89-Be prepared to provide medical and other documentation to 51
90-support your objection. For your protection, note the date when you 52
91-received this notice." 53
92-(3) (A) No proposed discontinuance or reduction shall become 54
93-effective unless specifically approved, in writing, by the administrative 55
94-law judge. The employee may request a hearing on any such proposed 56
95-discontinuance or reduction not later than fifteen days after receipt of 57
96-such notice. Any such request for a hearing shall be given priority over 58
97-requests for hearings on other matters. 59
98-(B) The administrative law judge shall not approve any such 60
99-proposed discontinuance or reduction prior to the expiration of the 61
100-period for requesting a hearing or the completion of such hearing, 62
101-whichever is later. 63
102-(4) If the administrative law judge finds that an employer, an 64
103-insurer acting on behalf of an employer or any other entity acting on 65
104-behalf of the employer or insurer discontinued or reduced any 66
105-payments made in accordance with this section without approval of an 67
106-administrative law judge, such employer, insurer or other entity shall 68
107-pay interest to the employee at a rate of one and one-quarter per cent 69
108-per month, or portion of a month, on any payments so discontinued or 70
109-on the total amount by which such payments were reduced, as the case 71
110-may be, plus reasonable attorney's fees incurred by the employee in 72
111-relation to such discontinuance or reduction. 73 Raised Bill No. 6550
76+LCO No. 3255 3 of 4
77+
78+If you object to the discontinuance of prescription payments as stated 44
79+in this notice, YOU MUST REQUEST A HEARING NOT LATER THAN 45
80+15 DAYS after your receipt of this notice, or this notice will 46
81+automatically take effect. 47
82+To request an Informal Hearing, call the Workers' Compensation 48
83+Commission District Office in which your case is pending. 49
84+Be prepared to provide medical and other documentation to support 50
85+your objection. For your protection, note the date when you received 51
86+this notice." 52
87+(3) (A) No proposed discontinuance or reduction shall become 53
88+effective unless specifically approved, in writing, by the administrative 54
89+law judge. The employee may request a hearing on any such proposed 55
90+discontinuance or reduction not later than fifteen days after receipt of 56
91+such notice. Any such request for a hearing shall be given priority over 57
92+requests for hearings on other matters. 58
93+(B) The administrative law judge shall not approve any such 59
94+proposed discontinuance or reduction prior to the expiration of the 60
95+period for requesting a hearing or the completion of such hearing, 61
96+whichever is later. 62
97+(4) If the administrative law judge finds that an employer, an insurer 63
98+acting on behalf of an employer or any other entity acting on behalf of 64
99+the employer or insurer discontinued or reduced any payments made 65
100+in accordance with this section without approval of an administrative 66
101+law judge, such employer, insurer or other entity shall pay interest to 67
102+the employee at a rate of one and one-quarter per cent per month, or 68
103+portion of a month, on any payments so discontinued or on the total 69
104+amount by which such payments were reduced, as the case may be, plus 70
105+reasonable attorney's fees incurred by the employee in relation to such 71
106+discontinuance or reduction. 72
107+[(2)] (5) If the injured employee is a local or state police officer, state 73
108+marshal, judicial marshal, correction officer, emergency medical 74 Raised Bill No. 6550
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118-[(2)] (5) If the injured employee is a local or state police officer, state 74
119-marshal, judicial marshal, correction officer, emergency medical 75
120-technician, paramedic, ambulance driver, firefighter, or active member 76
121-of a volunteer fire company or fire department engaged in volunteer 77
122-duties, who has been exposed in the line of duty to blood or bodily 78
123-fluids that may carry blood-borne disease, the medical and surgical aid 79
124-or hospital and nursing service provided by the employer shall include 80
125-any relevant diagnostic and prophylactic procedure for and treatment 81
126-of any blood-borne disease. 82
112+LCO No. 3255 4 of 4
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114+technician, paramedic, ambulance driver, firefighter, or active member 75
115+of a volunteer fire company or fire department engaged in volunteer 76
116+duties, who has been exposed in the line of duty to blood or bodily fluids 77
117+that may carry blood-borne disease, the medical and surgical aid or 78
118+hospital and nursing service provided by the employer shall include any 79
119+relevant diagnostic and prophylactic procedure for and treatment of any 80
120+blood-borne disease. 81
127121 This act shall take effect as follows and shall amend the following
128122 sections:
129123
130124 Section 1 October 1, 2023 31-294d(a)
131125
132-LAB Joint Favorable
126+Statement of Purpose:
127+To require employers or insurers acting on behalf of employers to (1)
128+provide notice of a proposed discontinuance or reduction of coverage of
129+an employee's prescription medication, and (2) obtain approval before
130+such discontinuance or reduction takes effect.
131+[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
132+that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
133+underlined.]
133134