Connecticut Senate Bill SB00185

Connecticut 2023 Regular Session

• Introduced: 1/17/23
• Refer: 1/17/23

Caption

An Act Prohibiting Health Insurers From Automatically Down-coding Health Insurance Claims And Requiring That Health Insurers Provide Justification For Down-coding A Health Insurance Claim.

Impact

If enacted, the bill would likely have significant implications for how health insurers operate in the state. By requiring justification for down-coding, the legislation aims to mitigate the negative effects that such practices can have on patient care and reimbursement processes. Moreover, it could lead to changes in internal policies for health insurance companies, necessitating that they clearly outline their rationale for any down-coding actions related to health claims.

Summary

SB00185 is a proposed bill aimed at addressing the practices of health insurers regarding the down-coding of insurance claims. Specifically, it prohibits health insurers from automatically down-coding claims without providing a valid justification. The motivation behind this bill is to enhance transparency and protect patient care, ensuring that patients receive the full benefits of their insured services without arbitrary reductions in claim payments.

Contention

The proposed bill has the potential to generate debate among various stakeholders in the healthcare industry. Supporters argue that the bill is essential for ensuring fair treatment of insured individuals and promoting quality healthcare services. On the other hand, opponents may raise concerns regarding the financial impact on insurers and the administrative burden that additional justification requirements could impose. Balancing the interests of patients and insurers will be a key point of contention as discussions around SB00185 proceed.