Connecticut 2024 Regular Session

Connecticut House Bill HB05488 Compare Versions

Version 1 (Old)

Version 2 (New)

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3		-	LCO 1 of 28
	3	+	LCO No. 2753 1 of 18
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5		-	General Assembly ~~Substitute~~ Bill No. 5488
	5	+	General Assembly Raised Bill No. 5488
6	6		February Session, 2024
	7	+	LCO No. 2753
7	8
	9	+
	10	+	Referred to Committee on PUBLIC HEALTH
	11	+
	12	+
	13	+	Introduced by:
	14	+	(PH)
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12	19		AN ACT CONCERNING VARIOUS REVISIONS TO THE PUBLIC
13	20		HEALTH STATUTES.
14	21		Be it enacted by the Senate and House of Representatives in General
15	22		Assembly convened:
16	23
17	24		Section 1. Section 19a-6s of the general statutes is repealed and the 1
18	25		following is substituted in lieu thereof (Effective from passage): 2
19	26		(a) For purposes of this section, "clinical medical assistant" means a 3
20	27		person who (1) (A) is certified by the American Association of Medical 4
21	28		Assistants, the National Healthcareer Association, the National Center 5
22	29		for Competency Testing, [or] the American Medical Technologists or the 6
23	30		American Medical Certification Association, and (B) has graduated 7
24	31		from a postsecondary medical assisting program (i) that is accredited by 8
25	32		the Commission on Accreditation of Allied Health Education Programs, 9
26	33		the Accrediting Bureau of Health Education Schools or another 10
27	34		accrediting organization recognized by the United States Department of 11
28	35		Education, or (ii) offered by an institution of higher education 12
29	36		accredited by an accrediting organization recognized by the United 13
30	37		States Department of Education and that includes a total of seven 14
31		-	hundred twenty hours, including one hundred sixty hours of clinical 15
	38	+	hundred twenty hours, including one hundred sixty hours of clinical 15 Raised Bill No. 5488
	39	+
	40	+
	41	+
	42	+	LCO No. 2753 2 of 18
	43	+
32	44		practice skills, including, but not limited to, administering injections, or 16
33	45		(2) has completed relevant medical assistant training provided by any 17
34		-	branch of the armed forces of the United States. 18 Substitute Bill No. 5488
35		-
36		-
37		-	LCO 2 of 28
38		-
	46	+	branch of the armed forces of the United States. 18
39	47		(b) A clinical medical assistant may administer a vaccine under the 19
40	48		supervision, control and responsibility of a physician licensed pursuant 20
41	49		to chapter 370, a physician assistant licensed pursuant to chapter 370 or 21
42	50		an advanced practice registered nurse licensed pursuant to chapter 378 22
43	51		to any person in any setting other than a hospital setting. Prior to 23
44	52		administering a vaccine, a clinical medical assistant shall complete not 24
45	53		less than twenty-four hours of classroom training and not less than eight 25
46	54		hours of training in a clinical setting regarding the administration of 26
47	55		vaccines. Nothing in this section shall be construed to permit an 27
48	56		employer of a physician, a physician assistant or an advanced practice 28
49	57		registered nurse to require the physician, physician assistant or 29
50	58		advanced practice registered nurse to oversee a clinical medical 30
51	59		assistant in the administration of a vaccine without the consent of the 31
52	60		physician, physician assistant or advanced practice registered nurse. 32
53	61		(c) On or before January first annually, the Commissioner of Public 33
54	62		Health shall obtain from the American Association of Medical 34
55	63		Assistants, the National Healthcareer Association, the National Center 35
56	64		for Competency Testing, [and] the American Medical Technologists and 36
57	65		the American Medical Certification Association a listing of all state 37
58	66		residents maintained on said organizations' registries of certified 38
59	67		medical assistants. The commissioner shall make such listings available 39
60	68		for public inspection. 40
61	69		Sec. 2. Subsection (b) of section 19a-127n of the 2024 supplement to 41
62	70		the general statutes is repealed and the following is substituted in lieu 42
63	71		thereof (Effective October 1, 2024): 43
64	72		(b) On and after October 1, 2023, a hospital or birth center, as such 44
65	73		terms are defined in section 19a-490, as amended by this act, or 45
66	74		outpatient surgical facility, as defined in section 19a-493b, shall report 46
67		-	adverse events to the Department of Public Health on a form prescribed 47
	75	+	adverse events to the Department of Public Health on a form prescribed 47 Raised Bill No. 5488
	76	+
	77	+
	78	+
	79	+	LCO No. 2753 3 of 18
	80	+
68	81		by the commissioner as follows: (1) A written report and the status of 48
69	82		any corrective steps shall be submitted not later than seven days after 49
70	83		the date on which the adverse event occurred; and (2) a corrective action 50
71		-	plan shall be filed not later than thirty days after the date on which the 51 Substitute Bill No. 5488
72		-
73		-
74		-	LCO 3 of 28
75		-
	84	+	plan shall be filed not later than thirty days after the date on which the 51
76	85		adverse event occurred. Emergent reports, as defined in the regulations 52
77	86		adopted pursuant to subsection (c) of this section, shall be made to the 53
78	87		department immediately. Failure to report an adverse event to the 54
79	88		department or implement a corrective action plan may result in 55
80	89		disciplinary action by the commissioner, pursuant to section 19a-494. 56
81	90		Sec. 3. Section 19a-197a of the 2024 supplement to the general statutes 57
82	91		is repealed and the following is substituted in lieu thereof (Effective 58
83	92		October 1, 2024): 59
84	93		(a) As used in this section, "emergency medical services personnel" 60
85	94		means (1) any class of emergency medical technician certified pursuant 61
86	95		to sections 20-206ll and 20-206mm, including, but not limited to, any 62
87	96		advanced emergency medical technician, (2) any paramedic licensed 63
88	97		pursuant to sections 20-206ll and 20-206mm, and (3) any emergency 64
89	98		medical responder certified pursuant to sections 20-206ll and 20-65
90	99		206mm. 66
91	100		(b) Any emergency medical services personnel who has been trained, 67
92	101		in accordance with national standards recognized by the Commissioner 68
93	102		of Public Health, in the administration of (1) epinephrine using 69
94	103		automatic prefilled cartridge injectors, similar automatic injectable 70
95	104		equipment or prefilled vial and syringe, or (2) glucagon nasal powder, 71
96	105		and who functions in accordance with written protocols and the 72
97	106		standing orders of a licensed physician serving as an emergency 73
98	107		department director [may administer, on or before June 30, 2024, and] 74
99	108		shall administer [, on and after July 1, 2024,] epinephrine using such 75
100	109		injectors, equipment or prefilled vial and syringe or glucagon nasal 76
101	110		powder when the use of epinephrine or glucagon is deemed necessary 77
102	111		by the emergency medical services personnel for the treatment of a 78
103	112		patient. All emergency medical services personnel shall receive such 79
104		-	training from an organization designated by the commissioner. 80
	113	+	training from an organization designated by the commissioner. 80 Raised Bill No. 5488
	114	+
	115	+
	116	+
	117	+	LCO No. 2753 4 of 18
	118	+
105	119		(c) All licensed or certified ambulances shall be equipped with 81
106	120		epinephrine in such injectors, equipment or prefilled vials and syringes 82
107		-	and glucagon nasal powder to be administered as described in 83 Substitute Bill No. 5488
108		-
109		-
110		-	LCO 4 of 28
111		-
	121	+	and glucagon nasal powder to be administered as described in 83
112	122		subsection (b) of this section and in accordance with written protocols 84
113	123		and standing orders of a licensed physician serving as an emergency 85
114	124		department director. 86
115	125		Sec. 4. Subsection (a) of section 20-195c of the 2024 supplement to the 87
116	126		general statutes is repealed and the following is substituted in lieu 88
117	127		thereof (Effective July 1, 2024): 89
118	128		(a) Each applicant for licensure as a marital and family therapist shall 90
119	129		present to the department satisfactory evidence that such applicant has: 91
120	130		(1) Completed a graduate degree program specializing in marital and 92
121	131		family therapy offered by a regionally accredited college or university 93
122	132		or an accredited postgraduate clinical training program accredited by 94
123	133		the Commission on Accreditation for Marriage and Family Therapy 95
124	134		Education offered by a regionally accredited institution of higher 96
125	135		education; (2) completed a supervised practicum or internship with 97
126	136		emphasis in marital and family therapy supervised by the program 98
127	137		granting the requisite degree or by an accredited postgraduate clinical 99
128	138		training program accredited by the Commission on Accreditation for 100
129	139		Marriage and Family Therapy Education and offered by a regionally 101
130	140		accredited institution of higher education; (3) completed [twelve] 102
131	141		twenty-four months of relevant postgraduate experience, including (A) 103
132	142		a minimum of one thousand hours of direct client contact offering 104
133	143		marital and family therapy services subsequent to being awarded a 105
134	144		master's degree or doctorate or subsequent to the training year specified 106
135	145		in subdivision (2) of this subsection, and (B) one hundred hours of 107
136	146		postgraduate clinical supervision provided by a licensed marital and 108
137	147		family therapist; and (4) passed an examination prescribed by the 109
138	148		department. The fee shall be two hundred dollars for each initial 110
139	149		application. 111
140	150		Sec. 5. Subdivision (3) of subsection (l) of section 19a-508c of the 2024 112
141		-	supplement to the general statutes is repealed and the following is 113
142		-	substituted in lieu thereof (Effective October 1, 2024): 114
143		-	(3) Notwithstanding the provisions of subdivisions (1) and (2) of this 115 Substitute Bill No. 5488
	151	+	supplement to the general statutes is repealed and the following is 113 Raised Bill No. 5488
144	152
145	153
146		-	LCO 5 of 28
147	154
	155	+	LCO No. 2753 5 of 18
	156	+
	157	+	substituted in lieu thereof (Effective October 1, 2024): 114
	158	+	(3) Notwithstanding the provisions of subdivisions (1) and (2) of this 115
148	159		subsection, in circumstances when an insurance contract that is in effect 116
149	160		on July 1, 2016, provides reimbursement for facility fees prohibited 117
150	161		under the provisions of subdivision (1) of this subsection, and in 118
151	162		circumstances when an insurance contract that is in effect on July 1, 119
152	163		2024, provides reimbursement for facility fees prohibited under the 120
153	164		provisions of subdivision (2) of this subsection, a hospital or health 121
154	165		system may continue to collect reimbursement from the health insurer 122
155	166		for such facility fees until the applicable date of expiration, renewal or 123
156	167		amendment of such contract, whichever such date is the earliest. A 124
157	168		violation of this subsection shall be considered an unfair trade practice 125
158	169		pursuant to chapter 735a. 126
159	170		Sec. 6. Section 20-7f of the general statutes is repealed and the 127
160	171		following is substituted in lieu thereof (Effective October 1, 2024): 128
161	172		(a) For purposes of this section: 129
162	173		(1) "Request payment" includes, but is not limited to, submitting a bill 130
163	174		for services not actually owed or submitting for such services an invoice 131
164	175		or other communication detailing the cost of the services that is not 132
165	176		clearly marked with the phrase "This is not a bill". 133
166	177		(2) "Health care provider" means a person licensed to provide health 134
167	178		care services under chapter 368d or 368v, chapters 370 to 373, inclusive, 135
168	179		chapters 375 to 383b, inclusive, chapters 384a to 384c, inclusive, or 136
169	180		chapter 400j. 137
170	181		(3) "Enrollee" means a person who has contracted for or who 138
171	182		participates in a health care plan for such enrollee or such enrollee's 139
172	183		eligible dependents. 140
173	184		(4) "Coinsurance, copayment, deductible or other out-of-pocket 141
174	185		expense" means the portion of a charge for services covered by a health 142
175		-	care plan that, under the plan's terms, it is the obligation of the enrollee 143
176		-	to pay. 144
177		-	(5) "Health care plan" has the same meaning as provided in 145 Substitute Bill No. 5488
	186	+	care plan that, under the plan's terms, it is the obligation of the enrollee 143 Raised Bill No. 5488
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179	188
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181	189
	190	+	LCO No. 2753 6 of 18
	191	+
	192	+	to pay. 144
	193	+	(5) "Health care plan" has the same meaning as provided in 145
182	194		subsection (a) of section 38a-477aa. 146
183	195		(6) "Health carrier" has the same meaning as provided in subsection 147
184	196		(a) of section 38a-477aa. 148
185	197		(7) "Emergency services" has the same meaning as provided in 149
186	198		subsection (a) of section 38a-477aa. 150
187	199		(b) It shall be an unfair trade practice in violation of chapter 735a for 151
188	200		any health care provider to request payment from an enrollee, other 152
189	201		than a coinsurance, copayment, deductible or other out-of-pocket 153
190	202		expense, for (1) health care services or a facility fee, as defined in section 154
191	203		19a-508c, as amended by this act, covered under a health care plan, (2) 155
192	204		emergency services, or services rendered to an insured at an urgent 156
193	205		crisis center, as defined in section 19a-179f, covered under a health care 157
194	206		plan and rendered by an out-of-network health care provider, or (3) a 158
195	207		surprise bill, as defined in section 38a-477aa. 159
196	208		(c) It shall be an unfair trade practice in violation of chapter 735a for 160
197	209		any health care provider to report to a credit reporting agency an 161
198	210		enrollee's failure to pay a bill for the services, facility fee or surprise bill 162
199	211		as set forth in subsection (b) of this section, when a health carrier has 163
200	212		primary responsibility for payment of such services, fees or bills. 164
201	213		Sec. 7. (NEW) (Effective from passage) Notwithstanding the provisions 165
202	214		of section 3-6c of the general statutes, the Governor may enter into a 166
203	215		compact, memorandum of understanding or agreement with any 167
204	216		federally recognized Indian tribe located within the geographical 168
205	217		boundaries of this state pursuant to which birth and death certificates 169
206	218		issued pursuant to chapter 93 of the general statutes concerning a birth 170
207	219		or death occurring on land held in trust by the United States for such 171
208	220		tribe shall be filed with and issued by the clerk or registrar of vital 172
209	221		statistics of such tribe in lieu of being filed with and issued by the 173
210		-	registrar of vital statistics of a town or municipality. 174
211		-	Sec. 8. Subsection (b) of section 20-195n of the 2024 supplement to the 175
212		-	general statutes is repealed and the following is substituted in lieu 176 Substitute Bill No. 5488
	222	+	registrar of vital statistics of a town or municipality. 174 Raised Bill No. 5488
213	223
214	224
215		-	LCO 7 of 28
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	226	+	LCO No. 2753 7 of 18
	227	+
	228	+	Sec. 8. Subsection (b) of section 20-195n of the 2024 supplement to the 175
	229	+	general statutes is repealed and the following is substituted in lieu 176
217	230		thereof (Effective from passage): 177
218	231		(b) An applicant for licensure as a master social worker shall: (1) (A) 178
219	232		Hold a master's degree from a social work program (i) accredited by the 179
220	233		Council on Social Work Education, or (ii) that is in candidate status for 180
221	234		accreditation by said council and offered by an institution of higher 181
222	235		education in the state during or after the spring semester of 2024, and 182
223	236		prior to the fall semester of 2027, or [,] (B) if educated outside the United 183
224	237		States or its territories, have completed an educational program deemed 184
225	238		equivalent by the council; and (2) pass the masters level examination of 185
226	239		the Association of Social Work Boards or any other examination 186
227	240		prescribed by the commissioner. 187
228	241		Sec. 9. Section 20-252 of the general statutes is repealed and the 188
229	242		following is substituted in lieu thereof (Effective October 1, 2024): 189
230	243		(a) No person shall engage in the occupation of registered hairdresser 190
231	244		and cosmetician without having obtained a license from the 191
232	245		department. Persons desiring such licenses shall apply in writing on 192
233	246		forms furnished by the department. No license shall be issued, except a 193
234	247		renewal of a license, to a registered hairdresser and cosmetician unless 194
235	248		the applicant has shown to the satisfaction of the department that the 195
236	249		applicant has complied with the laws and the regulations administered 196
237	250		or adopted by the department. No applicant shall be licensed as a 197
238	251		registered hairdresser and cosmetician, except by renewal of a license, 198
239	252		until the applicant has made written application to the department, 199
240	253		setting forth by affidavit that the applicant has (1) (A) successfully 200
241	254		completed the ninth grade, (B) completed a course of not less than 201
242	255		fifteen hundred hours of study in a school approved in accordance with 202
243	256		the provisions of this chapter or in a school teaching hairdressing and 203
244	257		cosmetology under the supervision of the State Board of Education, or, 204
245	258		if trained outside of Connecticut, in a school teaching hairdressing and 205
246	259		cosmetology whose requirements are equivalent to those of a 206
247		-	Connecticut school, and (C) passed a written examination satisfactory 207
248		-	to the department, or (2) if the applicant is an apprentice, (A) 208
249		-	successfully completed the eighth grade, (B) completed an 209 Substitute Bill No. 5488
	260	+	Connecticut school, and (C) passed a written examination satisfactory 207 Raised Bill No. 5488
250	261
251	262
252		-	LCO 8 of 28
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	264	+	LCO No. 2753 8 of 18
	265	+
	266	+	to the department, or (2) if the applicant is an apprentice, (A) 208
	267	+	successfully completed the eighth grade, (B) completed an 209
254	268		apprenticeship approved by the Labor Department and conducted in 210
255	269		accordance with sections 31-22m to 31-22u, inclusive, and (C) passed a 211
256	270		written examination satisfactory to the Department of Public Health. 212
257	271		Examinations required for licensure under this chapter shall be 213
258	272		prescribed by the department with the advice and assistance of the 214
259	273		board. The department shall establish a passing score for examinations 215
260	274		with the advice and assistance of the board which shall be the same as 216
261	275		the passing score established in section 20-236. 217
262	276		(b) No person applying for licensure as a hairdresser and cosmetician 218
263	277		under this chapter shall be required to submit to a state or national 219
264	278		criminal history records check as a prerequisite to licensure. 220
265	279		(c) The commissioner shall notify each applicant who is approved to 221
266	280		take a written examination required under subsection (a) of this section 222
267	281		that such applicant may be eligible for testing accommodations 223
268	282		pursuant to the federal Americans with Disabilities Act, 42 USC 12101 224
269	283		et seq., as amended from time to time, or other accommodations, as 225
270		-	determined by the board, which may ~~include the use of a dictionary~~ 226
271		-	while taking such examination and ~~additional time within which to take~~ 227
272		-	such examination. 228
	284	+	determined by the board, or its successor organization, which may 226
	285	+	include the use of a dictionary while taking such examination and 227
	286	+	additional time within which to take such examination. 228
273	287		Sec. 10. Section 20-12i of the general statutes is repealed and the 229
274	288		following is substituted in lieu thereof (Effective October 1, 2024): 230
275	289		(a) [On and after October 1, 2011, prior] Prior to engaging in the use 231
276	290		of fluoroscopy for guidance of diagnostic and therapeutic procedures, a 232
277	291		physician assistant or advanced practice registered nurse shall: (1) 233
278	292		Successfully complete a course that includes forty hours of didactic 234
279	293		instruction relevant to fluoroscopy which includes, but is not limited to, 235
280	294		radiation biology and physics, exposure reduction, equipment 236
281	295		operation, image evaluation, quality control and patient considerations; 237
282	296		(2) successfully complete a minimum of forty hours of supervised 238
283		-	clinical experience that includes a demonstration of patient dose 239
284		-	reduction, occupational dose reduction, image recording and quality 240
285		-	control of fluoroscopy equipment; and (3) pass an examination 241 Substitute Bill No. 5488
	297	+	clinical experience that includes a demonstration of patient dose 239 Raised Bill No. 5488
286	298
287	299
288		-	LCO 9 of 28
289	300
	301	+	LCO No. 2753 9 of 18
	302	+
	303	+	reduction, occupational dose reduction, image recording and quality 240
	304	+	control of fluoroscopy equipment; and (3) pass an examination 241
290	305		prescribed by the Commissioner of Public Health. Documentation that 242
291	306		the physician assistant or advanced practice registered nurse has met 243
292	307		the requirements prescribed in this subsection shall be maintained at the 244
293	308		employment site of the physician assistant or advanced practice 245
294	309		registered nurse and made available to the Department of Public Health 246
295	310		upon request. 247
296	311		(b) Notwithstanding the provisions of this section or sections 20-74bb 248
297	312		and 20-74ee, nothing shall prohibit a physician assistant who is 249
298	313		engaging in the use of fluoroscopy for guidance of diagnostic and 250
299	314		therapeutic procedures or positioning and utilizing a mini C-arm in 251
300	315		conjunction with fluoroscopic procedures prior to October 1, 2011, from 252
301	316		continuing to engage in such procedures, or require the physician 253
302	317		assistant to complete the course or supervised clinical experience 254
303	318		described in subsection (a) of this section, provided such physician 255
304	319		assistant shall pass the examination prescribed by the commissioner on 256
305	320		or before September 1, 2012. If a physician assistant does not pass the 257
306	321		required examination on or before September 1, 2012, such physician 258
307	322		assistant shall not engage in the use of fluoroscopy for guidance of 259
308	323		diagnostic and therapeutic procedures or position and utilize a mini C-260
309	324		arm in conjunction with fluoroscopic procedures until such time as such 261
310	325		physician assistant meets the requirements of subsection (a) of this 262
311	326		section. 263
312		-	Sec. 11. Section 19a-508c of the 2024 supplement to the general 264
313		-	statutes is repealed and the following is substituted in lieu thereof 265
314		-	(Effective October 1, 2024): 266
315		-	(a) As used in this section: 267
316		-	(1) "Affiliated provider" means a provider that is: (A) Employed by a 268
317		-	hospital or health system, (B) under a professional services agreement 269
318		-	with a hospital or health system that permits such hospital or health 270
319		-	system to bill on behalf of such provider, or (C) a clinical faculty member 271
320		-	of a medical school, as defined in section 33-182aa, that is affiliated with 272
321		-	a hospital or health system in a manner that permits such hospital or 273 Substitute Bill No. 5488
	327	+	Sec. 11. Subsection (b) of section 19a-508c of the 2024 supplement to 264
	328	+	the general statutes is repealed and the following is substituted in lieu 265
	329	+	thereof (Effective October 1, 2024): 266
	330	+	(b) If a hospital or health system charges a facility fee utilizing a 267
	331	+	current procedural terminology evaluation and management (CPT 268
	332	+	E/M) code, [or] assessment and management (CPT A/M) code , 269
	333	+	injection and infusion (CPT) code or drug administration (CPT) code for 270
	334	+	outpatient services provided at a hospital-based facility where a 271
	335	+	professional fee is also expected to be charged, the hospital or health 272 Raised Bill No. 5488
322	336
323	337
324		-	LCO 10 of 28
325	338
326		-	health system to bill on behalf of such clinical faculty member; 274
327		-	(2) "Campus" means: (A) The physical area immediately adjacent to a 275
328		-	hospital's main buildings and other areas and structures that are not 276
329		-	strictly contiguous to the main buildings but are located within two 277
330		-	hundred fifty yards of the main buildings, or (B) any other area that has 278
331		-	been determined on an individual case basis by the Centers for Medicare 279
332		-	and Medicaid Services to be part of a hospital's campus; 280
333		-	(3) "Facility fee" means any fee charged or billed by a hospital or 281
334		-	health system for outpatient services provided in a hospital-based 282
335		-	facility that is: (A) Intended to compensate the hospital or health system 283
336		-	for the operational expenses of the hospital or health system, and (B) 284
337		-	separate and distinct from a professional fee; 285
338		-	(4) "Health care provider" means an individual, entity, corporation, 286
339		-	person or organization, whether for-profit or nonprofit, that furnishes, 287
340		-	bills or is paid for health care service delivery in the normal course of 288
341		-	business, including, but not limited to, a health system, a hospital, a 289
342		-	hospital-based facility, a freestanding emergency department and an 290
343		-	urgent care center; 291
344		-	(5) "Health system" means: (A) A parent corporation of one or more 292
345		-	hospitals and any entity affiliated with such parent corporation through 293
346		-	ownership, governance, membership or other means, or (B) a hospital 294
347		-	and any entity affiliated with such hospital through ownership, 295
348		-	governance, membership or other means; 296
349		-	(6) "Hospital" has the same meaning as provided in section 19a-490, 297
350		-	as amended by this act; 298
351		-	(7) "Hospital-based facility" means a facility that is owned or 299
352		-	operated, in whole or in part, by a hospital or health system where 300
353		-	hospital or professional medical services are provided; 301
354		-	(8) "Medicaid" means the program operated by the Department of 302
355		-	Social Services pursuant to section 17b-260 and authorized by Title XIX 303 Substitute Bill No. 5488
	339	+	LCO No. 2753 10 of 18
	340	+
	341	+	system shall provide the patient with a written notice that includes the 273
	342	+	following information: 274
	343	+	(1) That the hospital-based facility is part of a hospital or health 275
	344	+	system and that the hospital or health system charges a facility fee that 276
	345	+	is in addition to and separate from the professional fee charged by the 277
	346	+	provider; 278
	347	+	(2) (A) The amount of the patient's potential financial liability, 279
	348	+	including any facility fee likely to be charged, and, where professional 280
	349	+	medical services are provided by an affiliated provider, any professional 281
	350	+	fee likely to be charged, or, if the exact type and extent of the 282
	351	+	professional medical services needed are not known or the terms of a 283
	352	+	patient's health insurance coverage are not known with reasonable 284
	353	+	certainty, an estimate of the patient's financial liability based on typical 285
	354	+	or average charges for visits to the hospital-based facility, including the 286
	355	+	facility fee, (B) a statement that the patient's actual financial liability will 287
	356	+	depend on the professional medical services actually provided to the 288
	357	+	patient, (C) an explanation that the patient may incur financial liability 289
	358	+	that is greater than the patient would incur if the professional medical 290
	359	+	services were not provided by a hospital-based facility, and (D) a 291
	360	+	telephone number the patient may call for additional information 292
	361	+	regarding such patient's potential financial liability, including an 293
	362	+	estimate of the facility fee likely to be charged based on the scheduled 294
	363	+	professional medical services; and 295
	364	+	(3) That a patient covered by a health insurance policy should contact 296
	365	+	the health insurer for additional information regarding the hospital's or 297
	366	+	health system's charges and fees, including the patient's potential 298
	367	+	financial liability, if any, for such charges and fees. 299
	368	+	Sec. 12. Subdivision (1) of subsection (l) of section 19a-508c of the 2024 300
	369	+	supplement to the general statutes is repealed and the following is 301
	370	+	substituted in lieu thereof (Effective October 1, 2024): 302
	371	+	(l) (1) Notwithstanding the provisions of this section, no hospital, 303
	372	+	health system or hospital-based facility shall collect a facility fee for (A) 304 Raised Bill No. 5488
356	373
357	374
358		-	LCO 11 of 28
359	375
360		-	of the Social Security Act, as amended from time to time; 304
361		-	(9) "Observation" means services furnished by a hospital on the 305
362		-	hospital's campus, regardless of length of stay, including use of a bed 306
363		-	and periodic monitoring by the hospital's nursing or other staff to 307
364		-	evaluate an outpatient's condition or determine the need for admission 308
365		-	to the hospital as an inpatient; 309
366		-	(10) "Payer mix" means the proportion of different sources of 310
367		-	payment received by a hospital or health system, including, but not 311
368		-	limited to, Medicare, Medicaid, other government-provided insurance, 312
369		-	private insurance and self-pay patients; 313
370		-	(11) "Professional fee" means any fee charged or billed by a provider 314
371		-	for professional medical services provided in a hospital-based facility; 315
372		-	(12) "Provider" means an individual, entity, corporation or health 316
373		-	care provider, whether for profit or nonprofit, whose primary purpose 317
374		-	is to provide professional medical services; and 318
375		-	(13) "Tagline" means a short statement written in a non-English 319
376		-	language that indicates the availability of language assistance services 320
377		-	free of charge. 321
378		-	(b) If a hospital or health system charges a facility fee utilizing a 322
379		-	current procedural terminology evaluation and management (CPT 323
380		-	E/M) code, [or] assessment and management (CPT A/M) code , 324
381		-	injection and infusion (CPT) code or drug administration (CPT) code for 325
382		-	outpatient services provided at a hospital-based facility where a 326
383		-	professional fee is also expected to be charged, the hospital or health 327
384		-	system shall provide the patient with a written notice that includes the 328
385		-	following information: 329
386		-	(1) That the hospital-based facility is part of a hospital or health 330
387		-	system and that the hospital or health system charges a facility fee that 331
388		-	is in addition to and separate from the professional fee charged by the 332
389		-	provider; 333 Substitute Bill No. 5488
	376	+	LCO No. 2753 11 of 18
	377	+
	378	+	outpatient health care services that use a current procedural 305
	379	+	terminology evaluation and management (CPT E/M) code , [or] 306
	380	+	assessment and management (CPT A/M) code, injection and infusion 307
	381	+	(CPT) code or drug administration (CPT) code and are provided at a 308
	382	+	hospital-based facility located off-site from a hospital campus, or (B) 309
	383	+	outpatient health care services provided at a hospital-based facility 310
	384	+	located off-site from a hospital campus received by a patient who is 311
	385	+	uninsured of more than the Medicare rate. 312
	386	+	Sec. 13. Subsection (d) of section 17a-673c of the 2024 supplement to 313
	387	+	the general statutes is repealed and the following is substituted in lieu 314
	388	+	thereof (Effective from passage): 315
	389	+	(d) The Commissioner of Mental Health and Addiction Services may 316
	390	+	request a disbursement of funds from the Opioid Settlement Fund 317
	391	+	established pursuant to section 17a-674c, in whole or in part, for the 318
	392	+	establishment and administration of the pilot program. 319
	393	+	Sec. 14. Subsection (c) of section 17a-674h of the 2024 supplement to 320
	394	+	the general statutes is repealed and the following is substituted in lieu 321
	395	+	thereof (Effective from passage): 322
	396	+	(c) Not later than January 1, 2024, the Department of Mental Health 323
	397	+	and Addiction Services, in collaboration with the Department of Public 324
	398	+	Health, shall use the Opioid Antagonist Bulk Purchase Fund for the 325
	399	+	provision of opioid antagonists to eligible entities and by emergency 326
	400	+	medical services personnel to certain members of the public. Emergency 327
	401	+	medical services personnel shall distribute an opioid antagonist kit 328
	402	+	containing a personal supply of opioid antagonists and the one-page 329
	403	+	fact sheet developed by the Connecticut Alcohol and Drug Policy 330
	404	+	Council pursuant to section 17a-667a regarding the risks of taking an 331
	405	+	opioid drug, symptoms of opioid use disorder and services available in 332
	406	+	the state for persons who experience symptoms of or are otherwise 333
	407	+	affected by opioid use disorder to a patient who (1) is treated by such 334
	408	+	personnel for an overdose of an opioid drug, (2) displays symptoms to 335
	409	+	such personnel of opioid use disorder, or (3) is treated at a location 336 Raised Bill No. 5488
390	410
391	411
392		-	LCO 12 of 28
393	412
394		-	(2) (A) The amount of the patient's potential financial liability, 334
395		-	including any facility fee likely to be charged, and, where professional 335
396		-	medical services are provided by an affiliated provider, any professional 336
397		-	fee likely to be charged, or, if the exact type and extent of the 337
398		-	professional medical services needed are not known or the terms of a 338
399		-	patient's health insurance coverage are not known with reasonable 339
400		-	certainty, an estimate of the patient's financial liability based on typical 340
401		-	or average charges for visits to the hospital-based facility, including the 341
402		-	facility fee, (B) a statement that the patient's actual financial liability will 342
403		-	depend on the professional medical services actually provided to the 343
404		-	patient, (C) an explanation that the patient may incur financial liability 344
405		-	that is greater than the patient would incur if the professional medical 345
406		-	services were not provided by a hospital-based facility, and (D) a 346
407		-	telephone number the patient may call for additional information 347
408		-	regarding such patient's potential financial liability, including an 348
409		-	estimate of the facility fee likely to be charged based on the scheduled 349
410		-	professional medical services; and 350
411		-	(3) That a patient covered by a health insurance policy should contact 351
412		-	the health insurer for additional information regarding the hospital's or 352
413		-	health system's charges and fees, including the patient's potential 353
414		-	financial liability, if any, for such charges and fees. 354
415		-	(c) If a hospital or health system charges a facility fee without 355
416		-	utilizing a current procedural terminology evaluation and management 356
417		-	(CPT E/M) code, assessment and management (CPT A/M) code, 357
418		-	injection and infusion (CPT) code or drug administration (CPT) code for 358
419		-	outpatient services provided at a hospital-based facility, located outside 359
420		-	the hospital campus, the hospital or health system shall provide the 360
421		-	patient with a written notice that includes the following information: 361
422		-	(1) That the hospital-based facility is part of a hospital or health 362
423		-	system and that the hospital or health system charges a facility fee that 363
424		-	may be in addition to and separate from the professional fee charged by 364
425		-	a provider; 365 Substitute Bill No. 5488
	413	+	LCO No. 2753 12 of 18
	414	+
	415	+	where such personnel observes evidence of illicit use of an opioid drug, 337
	416	+	or to such patient's family member, caregiver or friend who is present 338
	417	+	at the location. Emergency medical services personnel shall refer the 339
	418	+	patient or such patient's family member, caregiver or friend to the 340
	419	+	written instructions regarding the administration of such opioid 341
	420	+	antagonist, as deemed appropriate by such personnel. 342
	421	+	Sec. 15. Subdivision (5) of subsection (a) of section 19a-77 of the 2024 343
	422	+	supplement to the general statutes is repealed and the following is 344
	423	+	substituted in lieu thereof (Effective from passage): 345
	424	+	(5) ["Year-round" program] "Year-round program" means a program 346
	425	+	open at least fifty weeks per year. 347
	426	+	Sec. 16. Subsection (q) of section 19a-89e of the 2024 supplement to 348
	427	+	the general statutes is repealed and the following is substituted in lieu 349
	428	+	thereof (Effective from passage): 350
	429	+	(q) The Commissioner of Public Health may order an audit of the 351
	430	+	nurse staffing assignments of each hospital to determine compliance 352
	431	+	with the nurse staffing assignments for each hospital unit set forth in the 353
	432	+	nurse staffing plan developed pursuant to subsections (d) and (e) of this 354
	433	+	section. Such audit may include an assessment of the hospital's 355
	434	+	compliance with the requirements of this section for the content of such 356
	435	+	plan, accuracy of reports submitted to the department and the 357
	436	+	membership of the hospital staffing committee. In determining whether 358
	437	+	to order an audit, the commissioner shall consider whether there has 359
	438	+	been consistent noncompliance by the hospital with the nurse staffing 360
	439	+	plan, fear of false reporting by the hospital [,] or any other health care 361
	440	+	quality safety concerns. The hospital that is subject to the audit shall pay 362
	441	+	the cost of the audit. The audit shall not affect the conduct by the 363
	442	+	hospital of peer review as defined in section 19a-17b. 364
	443	+	Sec. 17. Subsection (a) of section 19a-133c of the 2024 supplement to 365
	444	+	the general statutes is repealed and the following is substituted in lieu 366
	445	+	thereof (Effective from passage): 367 Raised Bill No. 5488
426	446
427	447
428		-	LCO 13 of 28
429	448
430		-	(2) (A) A statement that the patient's actual financial liability will 366
431		-	depend on the professional medical services actually provided to the 367
432		-	patient, (B) an explanation that the patient may incur financial liability 368
433		-	that is greater than the patient would incur if the hospital-based facility 369
434		-	was not hospital-based, and (C) a telephone number the patient may call 370
435		-	for additional information regarding such patient's potential financial 371
436		-	liability, including an estimate of the facility fee likely to be charged 372
437		-	based on the scheduled professional medical services; and 373
438		-	(3) That a patient covered by a health insurance policy should contact 374
439		-	the health insurer for additional information regarding the hospital's or 375
440		-	health system's charges and fees, including the patient's potential 376
441		-	financial liability, if any, for such charges and fees. 377
442		-	(d) Each initial billing statement that includes a facility fee shall: (1) 378
443		-	Clearly identify the fee as a facility fee that is billed in addition to, or 379
444		-	separately from, any professional fee billed by the provider; (2) provide 380
445		-	the corresponding Medicare facility fee reimbursement rate for the same 381
446		-	service as a comparison or, if there is no corresponding Medicare facility 382
447		-	fee for such service, (A) the approximate amount Medicare would have 383
448		-	paid the hospital for the facility fee on the billing statement, or (B) the 384
449		-	percentage of the hospital's charges that Medicare would have paid the 385
450		-	hospital for the facility fee; (3) include a statement that the facility fee is 386
451		-	intended to cover the hospital's or health system's operational expenses; 387
452		-	(4) inform the patient that the patient's financial liability may have been 388
453		-	less if the services had been provided at a facility not owned or operated 389
454		-	by the hospital or health system; and (5) include written notice of the 390
455		-	patient's right to request a reduction in the facility fee or any other 391
456		-	portion of the bill and a telephone number that the patient may use to 392
457		-	request such a reduction without regard to whether such patient 393
458		-	qualifies for, or is likely to be granted, any reduction. Not later than 394
459		-	October 15, 2022, and annually thereafter, each hospital, health system 395
460		-	and hospital-based facility shall submit to the Health Systems Planning 396
461		-	Unit of the Office of Health Strategy a sample of a billing statement 397
462		-	issued by such hospital, health system or hospital-based facility that 398
463		-	complies with the provisions of this subsection and which represents 399 Substitute Bill No. 5488
	449	+	LCO No. 2753 13 of 18
	450	+
	451	+	(a) As used in this section, "structural racism" means a system that 368
	452	+	structures opportunity and assigns value in a way that 369
	453	+	disproportionally and negatively impacts Black, Indigenous, Latino or 370
	454	+	Asian people or other people of color, and "state agency" has the same 371
	455	+	meaning as provided in section 1-79. The Commission on Racial Equity 372
	456	+	in Public Health, established under section 19a-133a, shall recommend 373
	457	+	best practices for state agencies to (1) evaluate structural racism within 374
	458	+	their own policies, practices [,] and operations, and (2) create and 375
	459	+	implement a plan, which includes the establishment of benchmarks for 376
	460	+	improvement, to ultimately eliminate any such structural racism within 377
	461	+	the agency. 378
	462	+	Sec. 18. Subdivision (1) of subsection (k) of section 19a-508c of the 379
	463	+	2024 supplement to the general statutes is repealed and the following is 380
	464	+	substituted in lieu thereof (Effective from passage): 381
	465	+	(k) (1) If any transaction described in subsection (c) of section 19a-382
	466	+	486i [,] results in the establishment of a hospital-based facility at which 383
	467	+	facility fees may be billed, the hospital or health system, that is the 384
	468	+	purchaser in such transaction shall, not later than thirty days after such 385
	469	+	transaction, provide written notice, by first class mail, of the transaction 386
	470	+	to each patient served within the three years preceding the date of the 387
	471	+	transaction by the health care facility that has been purchased as part of 388
	472	+	such transaction. 389
	473	+	Sec. 19. Subdivision (21) of section 20-73e of the 2024 supplement to 390
	474	+	the general statutes is repealed and the following is substituted in lieu 391
	475	+	thereof (Effective from passage): 392
	476	+	(21) "Rule" means a regulation, principle [,] or directive promulgated 393
	477	+	by the commission that has the force of law; and 394
	478	+	Sec. 20. Subparagraph (B) of subdivision (2) of subsection (b) of 395
	479	+	section 20-87a of the 2024 supplement to the general statutes is repealed 396
	480	+	and the following is substituted in lieu thereof (Effective from passage): 397
	481	+	(B) An advanced practice registered nurse having been issued a 398 Raised Bill No. 5488
464	482
465	483
466		-	LCO 14 of 28
467	484
468		-	~~the format~~ of ~~billing statements received by patients. Such billing 400~~
469		-	~~statement shall not contain patient identifying information. 401~~
470		-	~~(e) The written notice described in subsections (b)~~ to (d), ~~inclusive, 402~~
471		-	~~and (h)~~ to ~~(j), inclusive,~~ of ~~this section shall be in plain language and in 403~~
472		-	~~a form that~~ may ~~be reasonably understood by a patient who does not 404~~
473		-	~~possess special knowledge regarding hospital or health system facility 405~~
474		-	~~fee charges. On and after October 1~~, ~~2022,~~ such ~~notices shall include tag 406~~
475		-	~~lines~~ in ~~at least the top fifteen languages spoken in the state indicating 407~~
476		-	~~that~~ the ~~notice is available in each of those top fifteen languages. The 408~~
477		-	~~fifteen languages shall be either~~ the ~~languages~~ in ~~the list published by 409~~
478		-	~~the Department of Health and Human Services in connection with 410~~
479		-	~~section 1557 of the Patient Protection and Affordable~~ Care ~~Act, P.L. 111-411~~
480		-	~~148, or,~~ ~~as determined by~~ the ~~hospital or~~ health ~~system~~, ~~the top fifteen 412~~
481		-	~~languages in the geographic area~~ of the ~~hospital-based facility.~~ ~~413~~
482		-	~~(f) (1) For nonemergency care, if a patient's appointment~~ is ~~scheduled 414~~
483		-	~~to occur ten or more days after the appointment is made, such written 415~~
484		-	~~notice shall be sent~~ to ~~the patient by first class mail, encrypted electronic 416~~
485		-	~~mail or a secure patient Internet portal not less than three days after~~ the ~~417~~
486		-	~~appointment is made.~~ ~~If an appointment is scheduled to occur less than 418~~
487		-	~~ten days~~ after ~~the appointment is made or if the patient arrives without 419~~
488		-	~~an appointment,~~ ~~such notice~~ shall ~~be hand-delivered~~ ~~to the patient when 420~~
489		-	~~the patient arrives at~~ the ~~hospital-based facility.~~ ~~421~~
490		-	(2) For ~~emergency care,~~ ~~such written notice shall be provided to~~ the ~~422~~
491		-	~~patient as soon as practicable after the patient is stabilized in accordance 423~~
492		-	~~with the federal Emergency Medical Treatment and Active Labor Act, 424~~
493		-	~~42 USC 1395dd, as amended from time to time,~~ or is ~~determined~~ not ~~to 425~~
494		-	~~have an emergency medical condition and before the patient leaves the 426~~
495		-	~~hospital-based facility.~~ If the ~~patient is unconscious,~~ ~~under great duress 427~~
496		-	or ~~for any other reason unable to read the notice and understand and 428~~
497		-	~~act on his or her rights, the notice shall be provided to the patient's 429~~
498		-	~~representative as soon as practicable.~~ ~~430~~
499		-	~~(g) Subsections (b)~~ to ~~(f)~~, ~~inclusive, and (l) of this section shall not 431 Substitute~~ Bill No. 5488
	485	+	LCO No. 2753 14 of 18
	486	+
	487	+	license pursuant to subsection (d) of section 20-94a who collaborated, 399
	488	+	prior to the issuance of such license, with a physician licensed to practice 400
	489	+	medicine in another state may count the time of such collaboration 401
	490	+	toward the three-year requirement set forth in subparagraph (A) of this 402
	491	+	[subsection] subdivision, provided such collaboration otherwise 403
	492	+	satisfies the requirements set forth in said subparagraph. 404
	493	+	Sec. 21. Subsection (d) of section 20-185aa of the 2024 supplement to 405
	494	+	the general statutes is repealed and the following is substituted in lieu 406
	495	+	thereof (Effective from passage): 407
	496	+	(d) Any health care facility that employs or retains a surgical 408
	497	+	technologist shall submit to the Department of Public Health, upon 409
	498	+	request of the department, documentation [demonstration] 410
	499	+	demonstrating that the surgical technologist is in compliance with the 411
	500	+	requirements set forth in this section. 412
	501	+	Sec. 22. Subsection (b) of section 38a-479jjj of the 2024 supplement to 413
	502	+	the general statutes is repealed and the following is substituted in lieu 414
	503	+	thereof (Effective from passage): 415
	504	+	(b) On and after January 1, 2024, a contract entered into between a 416
	505	+	pharmacy [benefit] benefits manager and a 340B covered entity shall not 417
	506	+	contain any of the following provisions: 418
	507	+	(1) A reimbursement rate for a prescription drug that is less than the 419
	508	+	reimbursement rate paid to pharmacies that are not 340B covered 420
	509	+	entities; 421
	510	+	(2) A fee or adjustment that is not imposed on providers or 422
	511	+	pharmacies that are not 340B covered entities; 423
	512	+	(3) A fee or adjustment amount that exceeds the fee or adjustment 424
	513	+	amount imposed on providers or pharmacies that are not 340B covered 425
	514	+	entities; 426
	515	+	(4) Any provision that prevents or interferes with a patient's choice 427
	516	+	to receive a prescription drug from a 340B covered entity, including the 428 Raised Bill No. 5488
500	517
501	518
502		-	LCO 15 of 28
503	519
504		-	apply if a patient is insured by Medicare or Medicaid or is receiving 432
505		-	services under a workers' compensation plan established to provide 433
506		-	medical services pursuant to chapter 568. 434
507		-	(h) A hospital-based facility shall prominently display written notice 435
508		-	in locations that are readily accessible to and visible by patients, 436
509		-	including patient waiting or appointment check-in areas, stating: (1) 437
510		-	That the hospital-based facility is part of a hospital or health system, (2) 438
511		-	the name of the hospital or health system, and (3) that if the hospital-439
512		-	based facility charges a facility fee, the patient may incur a financial 440
513		-	liability greater than the patient would incur if the hospital-based 441
514		-	facility was not hospital-based. On and after October 1, 2022, such 442
515		-	notices shall include tag lines in at least the top fifteen languages spoken 443
516		-	in the state indicating that the notice is available in each of those top 444
517		-	fifteen languages. The fifteen languages shall be either the languages in 445
518		-	the list published by the Department of Health and Human Services in 446
519		-	connection with section 1557 of the Patient Protection and Affordable 447
520		-	Care Act, P.L. 111-148, or, as determined by the hospital or health 448
521		-	system, the top fifteen languages in the geographic area of the hospital-449
522		-	based facility. Not later than October 1, 2022, and annually thereafter, 450
523		-	each hospital-based facility shall submit a copy of the written notice 451
524		-	required by this subsection to the Health Systems Planning Unit of the 452
525		-	Office of Health Strategy. 453
526		-	(i) A hospital-based facility shall clearly hold itself out to the public 454
527		-	and payers as being hospital-based, including, at a minimum, by stating 455
528		-	the name of the hospital or health system in its signage, marketing 456
529		-	materials, Internet web sites and stationery. 457
530		-	(j) A hospital-based facility shall, when scheduling services for which 458
531		-	a facility fee may be charged, inform the patient (1) that the hospital-459
532		-	based facility is part of a hospital or health system, (2) of the name of the 460
533		-	hospital or health system, (3) that the hospital or health system may 461
534		-	charge a facility fee in addition to and separate from the professional fee 462
535		-	charged by the provider, and (4) of the telephone number the patient 463
536		-	may call for additional information regarding such patient's potential 464 Substitute Bill No. 5488
	520	+	LCO No. 2753 15 of 18
	521	+
	522	+	administration of the drug; and 429
	523	+	(5) Any provision that excludes a 340B covered entity from pharmacy 430
	524	+	[benefit] benefits manager networks based on the 340B covered entity's 431
	525	+	participation in the federal 340B Drug Pricing Program. 432
	526	+	Sec. 23. Subsection (d) of section 38a-518v of the 2024 supplement to 433
	527	+	the general statutes is repealed and the following is substituted in lieu 434
	528	+	thereof (Effective from passage): 435
	529	+	(d) Nothing in this section shall prohibit or limit a health insurer, 436
	530	+	health care center, hospital service corporation, medical service 437
	531	+	corporation or other entity from conducting utilization review for an in-438
	532	+	home hospice [services] service, provided such utilization review is 439
	533	+	conducted in the same manner and uses the same clinical review criteria 440
	534	+	as a utilization review for the same hospice services provided in a 441
	535	+	hospital. 442
	536	+	Sec. 24. Subsection (c) of section 10-532 of the 2024 supplement to the 443
	537	+	general statutes is repealed and the following is substituted in lieu 444
	538	+	thereof (Effective October 1, 2024): 445
	539	+	(c) When developing the program, said commissioners and executive 446
	540	+	director [,] shall (1) consult with insurers that offer health benefit plans 447
	541	+	in the state, hospitals, local public health authorities, existing early 448
	542	+	childhood home visiting programs, community-based organizations 449
	543	+	and social service providers; and (2) maximize the use of available 450
	544	+	federal funding. 451
	545	+	Sec. 25. Subsection (g) of section 19a-59j of the 2024 supplement to the 452
	546	+	general statutes is repealed and the following is substituted in lieu 453
	547	+	thereof (Effective October 1, 2024): 454
	548	+	(g) Notwithstanding any provision of the general statutes, the 455
	549	+	commissioner, or the commissioner's designee, may provide the infant 456
	550	+	mortality review committee, established pursuant to section 19a-59k, 457
	551	+	with information as is necessary, in the commissioner's discretion, for 458 Raised Bill No. 5488
537	552
538	553
539		-	LCO 16 of 28
540	554
541		-	financial liability. 465
542		-	(k) (1) If any transaction described in subsection (c) of section 19a-466
543		-	486i, results in the establishment of a hospital-based facility at which 467
544		-	facility fees may be billed, the hospital or health system, that is the 468
545		-	purchaser in such transaction shall, not later than thirty days after such 469
546		-	transaction, provide written notice, by first class mail, of the transaction 470
547		-	to each patient served within the three years preceding the date of the 471
548		-	transaction by the health care facility that has been purchased as part of 472
549		-	such transaction. 473
550		-	(2) Such notice shall include the following information: 474
551		-	(A) A statement that the health care facility is now a hospital-based 475
552		-	facility and is part of a hospital or health system, the health care facility's 476
553		-	full legal and business name and the date of such facility's acquisition 477
554		-	by a hospital or health system; 478
555		-	(B) The name, business address and phone number of the hospital or 479
556		-	health system that is the purchaser of the health care facility; 480
557		-	(C) A statement that the hospital-based facility bills, or is likely to bill, 481
558		-	patients a facility fee that may be in addition to, and separate from, any 482
559		-	professional fee billed by a health care provider at the hospital-based 483
560		-	facility; 484
561		-	(D) (i) A statement that the patient's actual financial liability will 485
562		-	depend on the professional medical services actually provided to the 486
563		-	patient, and (ii) an explanation that the patient may incur financial 487
564		-	liability that is greater than the patient would incur if the hospital-based 488
565		-	facility were not a hospital-based facility; 489
566		-	(E) The estimated amount or range of amounts the hospital-based 490
567		-	facility may bill for a facility fee or an example of the average facility fee 491
568		-	billed at such hospital-based facility for the most common services 492
569		-	provided at such hospital-based facility; and 493
570		-	(F) A statement that, prior to seeking services at such hospital-based 494 Substitute Bill No. 5488
	555	+	LCO No. 2753 16 of 18
	556	+
	557	+	the committee to make recommendations regarding the prevention of 459
	558	+	infant deaths. 460
	559	+	Sec. 26. Subdivision (3) of section 19a-111b of the 2024 supplement to 461
	560	+	the general statutes is repealed and the following is substituted in lieu 462
	561	+	thereof (Effective October 1, 2024): 463
	562	+	(3) The commissioner shall establish a program for the detection of 464
	563	+	sources of lead poisoning. Within available appropriations, such 465
	564	+	program shall include the identification of dwellings in which paint, 466
	565	+	plaster or other accessible substances contain toxic levels of lead and the 467
	566	+	inspection of areas surrounding such dwellings for lead-containing 468
	567	+	materials. Any person who detects a toxic level of lead, as defined by 469
	568	+	the commissioner, shall report such findings to the commissioner. The 470
	569	+	commissioner shall inform all interested parties, including, but not 471
	570	+	limited to, the owner of the building, the occupants of the building, 472
	571	+	enforcement officials and other necessary parties. 473
	572	+	Sec. 27. Subsection (l) of section 19a-490 of the 2024 supplement to the 474
	573	+	general statutes is repealed and the following is substituted in lieu 475
	574	+	thereof (Effective October 1, 2024): 476
	575	+	(l) "Assisted living services agency" means an agency that provides 477
	576	+	chronic and stable individuals with services that include, but need not 478
	577	+	be limited to, nursing services and assistance with activities of daily 479
	578	+	living and may have a dementia special care unit or program as defined 480
	579	+	in section 19a-562; 481
	580	+	Sec. 28. Subdivisions (2) and (3) of subsection (b) of section 19a-181 of 482
	581	+	the 2024 supplement to the general statutes are repealed and the 483
	582	+	following is substituted in lieu thereof (Effective October 1, 2024): 484
	583	+	(2) Each authorized emergency medical [service] services vehicle 485
	584	+	shall be equipped with the equipment required for its specific vehicle 486
	585	+	classification as specified in the 2022 Connecticut EMS Minimum 487
	586	+	Equipment Checklist, as amended from time to time; and 488 Raised Bill No. 5488
571	587
572	588
573		-	LCO 17 of 28
574	589
575		-	facility, a patient covered by a health insurance policy should contact 495
576		-	the patient's health insurer for additional information regarding the 496
577		-	hospital-based facility fees, including the patient's potential financial 497
578		-	liability, if any, for such fees. 498
579		-	(3) A copy of the written notice provided to patients in accordance 499
580		-	with this subsection shall be filed with the Health Systems Planning 500
581		-	Unit of the Office of Health Strategy, established under section 19a-612. 501
582		-	Said unit shall post a link to such notice on its Internet web site. 502
583		-	(4) A hospital, health system or hospital-based facility shall not collect 503
584		-	a facility fee for services provided at a hospital-based facility that is 504
585		-	subject to the provisions of this subsection from the date of the 505
586		-	transaction until at least thirty days after the written notice required 506
587		-	pursuant to this subsection is mailed to the patient or a copy of such 507
588		-	notice is filed with the Health Systems Planning Unit of the Office of 508
589		-	Health Strategy, whichever is later. A violation of this subsection shall 509
590		-	be considered an unfair trade practice pursuant to section 42-110b. 510
591		-	(5) Not later than July 1, 2023, and annually thereafter, each hospital-511
592		-	based facility that was the subject of a transaction, as described in 512
593		-	subsection (c) of section 19a-486i, during the preceding calendar year 513
594		-	shall report to the Health Systems Planning Unit of the Office of Health 514
595		-	Strategy the number of patients served by such hospital-based facility 515
596		-	in the preceding three years. 516
597		-	(l) (1) Notwithstanding the provisions of this section, no hospital, 517
598		-	health system or hospital-based facility shall collect a facility fee for (A) 518
599		-	outpatient health care services that use a current procedural 519
600		-	terminology evaluation and management (CPT E/M) code , [or] 520
601		-	assessment and management (CPT A/M) code, injection and infusion 521
602		-	(CPT) code or drug administration (CPT) code and are provided at a 522
603		-	hospital-based facility located off-site from a hospital campus, or (B) 523
604		-	outpatient health care services provided at a hospital-based facility 524
605		-	located off-site from a hospital campus received by a patient who is 525
606		-	uninsured of more than the Medicare rate. 526 Substitute Bill No. 5488
	590	+	LCO No. 2753 17 of 18
607	591
608		-
609		-	LCO 18 of 28
610		-
611		-	(2) Notwithstanding the provisions of this section, on and after July 527
612		-	1, 2024, no hospital or health system shall collect a facility fee for 528
613		-	outpatient health care services that use a current procedural 529
614		-	terminology evaluation and management (CPT E/M) code or 530
615		-	assessment and management (CPT A/M) code and are provided on the 531
616		-	hospital campus. The provisions of this subdivision shall not apply to 532
617		-	(A) an emergency department located on a hospital campus, or (B) 533
618		-	observation stays on a hospital campus and (CPT E/M) and (CPT A/M) 534
619		-	codes when billed for the following services: (i) Wound care, (ii) 535
620		-	orthopedics, (iii) anticoagulation, (iv) oncology, (v) obstetrics, and (vi) 536
621		-	solid organ transplant. 537
622		-	(3) Notwithstanding the provisions of subdivisions (1) and (2) of this 538
623		-	subsection, in circumstances when an insurance contract that is in effect 539
624		-	on July 1, 2016, provides reimbursement for facility fees prohibited 540
625		-	under the provisions of subdivision (1) of this subsection, and in 541
626		-	circumstances when an insurance contract that is in effect on July 1, 542
627		-	2024, provides reimbursement for facility fees prohibited under the 543
628		-	provisions of subdivision (2) of this subsection, a hospital or health 544
629		-	system may continue to collect reimbursement from the health insurer 545
630		-	for such facility fees until the applicable date of expiration, renewal or 546
631		-	amendment of such contract, whichever such date is the earliest. 547
632		-	(4) The provisions of this subsection shall not apply to a freestanding 548
633		-	emergency department. As used in this subdivision, "freestanding 549
634		-	emergency department" means a freestanding facility that (A) is 550
635		-	structurally separate and distinct from a hospital, (B) provides 551
636		-	emergency care, (C) is a department of a hospital licensed under chapter 552
637		-	368v, and (D) has been issued a certificate of need to operate as a 553
638		-	freestanding emergency department pursuant to chapter 368z. 554
639		-	(5) (A) On and after July 1, 2024, if the executive director of the Office 555
640		-	of Health Strategy receives information and has a reasonable belief, after 556
641		-	evaluating such information, that any hospital, health system or 557
642		-	hospital-based facility charged facility fees, other than through isolated 558
643		-	clerical or electronic billing errors, in violation of any provision of this 559 Substitute Bill No. 5488
644		-
645		-
646		-	LCO 19 of 28
647		-
648		-	section, or rule or regulation adopted thereunder, such hospital, health 560
649		-	system or hospital-based facility shall be subject to a civil penalty of up 561
650		-	to one thousand dollars. The executive director may issue a notice of 562
651		-	violation and civil penalty by first class mail or personal service. Such 563
652		-	notice shall include: (i) A reference to the section of the general statutes, 564
653		-	rule or section of the regulations of Connecticut state agencies believed 565
654		-	or alleged to have been violated; (ii) a short and plain language 566
655		-	statement of the matters asserted or charged; (iii) a description of the 567
656		-	activity to cease; (iv) a statement of the amount of the civil penalty or 568
657		-	penalties that may be imposed; (v) a statement concerning the right to a 569
658		-	hearing; and (vi) a statement that such hospital, health system or 570
659		-	hospital-based facility may, not later than ten business days after receipt 571
660		-	of such notice, make a request for a hearing on the matters asserted. 572
661		-	(B) The hospital, health system or hospital-based facility to whom 573
662		-	such notice is provided pursuant to subparagraph (A) of this 574
663		-	subdivision may, not later than ten business days after receipt of such 575
664		-	notice, make written application to the Office of Health Strategy to 576
665		-	request a hearing to demonstrate that such violation did not occur. The 577
666		-	failure to make a timely request for a hearing shall result in the issuance 578
667		-	of a cease and desist order or civil penalty. All hearings held under this 579
668		-	subsection shall be conducted in accordance with the provisions of 580
669		-	chapter 54. 581
670		-	(C) Following any hearing before the Office of Health Strategy 582
671		-	pursuant to this subdivision, if said office finds, by a preponderance of 583
672		-	the evidence, that such hospital, health system or hospital-based facility 584
673		-	violated or is violating any provision of this subsection, any rule or 585
674		-	regulation adopted thereunder or any order issued by said office, said 586
675		-	office shall issue a final cease and desist order in addition to any civil 587
676		-	penalty said office imposes. 588
677		-	(m) (1) Each hospital and health system shall report not later than 589
678		-	October 1, 2023, and thereafter not later than July 1, 2024, and annually 590
679		-	thereafter, to the executive director of the Office of Health Strategy, on 591
680		-	a form prescribed by the executive director, concerning facility fees 592 Substitute Bill No. 5488
681		-
682		-
683		-	LCO 20 of 28
684		-
685		-	charged or billed during the preceding calendar year. Such report shall 593
686		-	include, but need not be limited to, (A) the name and address of each 594
687		-	facility owned or operated by the hospital or health system that 595
688		-	provides services for which a facility fee is charged or billed, and an 596
689		-	indication as to whether each facility is located on or outside of the 597
690		-	hospital or health system campus, (B) the number of patient visits at 598
691		-	each such facility for which a facility fee was charged or billed, (C) the 599
692		-	number, total amount and range of allowable facility fees paid at each 600
693		-	such facility disaggregated by payer mix, (D) for each facility, the total 601
694		-	amount of facility fees charged and the total amount of revenue received 602
695		-	by the hospital or health system derived from facility fees, (E) the total 603
696		-	amount of facility fees charged and the total amount of revenue received 604
697		-	by the hospital or health system from all facilities derived from facility 605
698		-	fees, (F) a description of the ten procedures or services that generated 606
699		-	the greatest amount of facility fee gross revenue, disaggregated by 607
700		-	current procedural terminology category (CPT) code for each such 608
701		-	procedure or service and, for each such procedure or service, patient 609
702		-	volume and the total amount of gross and net revenue received by the 610
703		-	hospital or health system derived from facility fees, disaggregated by 611
704		-	on-campus and off-campus, and (G) the top ten procedures or services 612
705		-	for which facility fees are charged based on patient volume and the 613
706		-	gross and net revenue received by the hospital or health system for each 614
707		-	such procedure or service, disaggregated by on-campus and off-615
708		-	campus. For purposes of this subsection, "facility" means a hospital-616
709		-	based facility that is located on a hospital campus or outside a hospital 617
710		-	campus. 618
711		-	(2) The executive director shall publish the information reported 619
712		-	pursuant to subdivision (1) of this subsection, or post a link to such 620
713		-	information, on the Internet web site of the Office of Health Strategy. 621
714		-	Sec. 12. Subsection (d) of section 17a-673c of the 2024 supplement to 622
715		-	the general statutes is repealed and the following is substituted in lieu 623
716		-	thereof (Effective from passage): 624
717		-	(d) The Commissioner of Mental Health and Addiction Services may 625 Substitute Bill No. 5488
718		-
719		-
720		-	LCO 21 of 28
721		-
722		-	request a disbursement of funds from the Opioid Settlement Fund 626
723		-	established pursuant to section 17a-674c, in whole or in part, for the 627
724		-	establishment and administration of the pilot program. 628
725		-	Sec. 13. Subsection (c) of section 17a-674h of the 2024 supplement to 629
726		-	the general statutes is repealed and the following is substituted in lieu 630
727		-	thereof (Effective from passage): 631
728		-	(c) Not later than January 1, 2024, the Department of Mental Health 632
729		-	and Addiction Services, in collaboration with the Department of Public 633
730		-	Health, shall use the Opioid Antagonist Bulk Purchase Fund for the 634
731		-	provision of opioid antagonists to eligible entities and by emergency 635
732		-	medical services personnel to certain members of the public. Emergency 636
733		-	medical services personnel shall distribute an opioid antagonist kit 637
734		-	containing a personal supply of opioid antagonists and the one-page 638
735		-	fact sheet developed by the Connecticut Alcohol and Drug Policy 639
736		-	Council pursuant to section 17a-667a regarding the risks of taking an 640
737		-	opioid drug, symptoms of opioid use disorder and services available in 641
738		-	the state for persons who experience symptoms of or are otherwise 642
739		-	affected by opioid use disorder to a patient who (1) is treated by such 643
740		-	personnel for an overdose of an opioid drug, (2) displays symptoms to 644
741		-	such personnel of opioid use disorder, or (3) is treated at a location 645
742		-	where such personnel observes evidence of illicit use of an opioid drug, 646
743		-	or to such patient's family member, caregiver or friend who is present 647
744		-	at the location. Emergency medical services personnel shall refer the 648
745		-	patient or such patient's family member, caregiver or friend to the 649
746		-	written instructions regarding the administration of such opioid 650
747		-	antagonist, as deemed appropriate by such personnel. 651
748		-	Sec. 14. Subdivision (5) of subsection (a) of section 19a-77 of the 2024 652
749		-	supplement to the general statutes is repealed and the following is 653
750		-	substituted in lieu thereof (Effective from passage): 654
751		-	(5) ["Year-round" program] "Year-round program" means a program 655
752		-	open at least fifty weeks per year. 656
753		-	Sec. 15. Subsection (q) of section 19a-89e of the 2024 supplement to 657 Substitute Bill No. 5488
754		-
755		-
756		-	LCO 22 of 28
757		-
758		-	the general statutes is repealed and the following is substituted in lieu 658
759		-	thereof (Effective from passage): 659
760		-	(q) The Commissioner of Public Health may order an audit of the 660
761		-	nurse staffing assignments of each hospital to determine compliance 661
762		-	with the nurse staffing assignments for each hospital unit set forth in the 662
763		-	nurse staffing plan developed pursuant to subsections (d) and (e) of this 663
764		-	section. Such audit may include an assessment of the hospital's 664
765		-	compliance with the requirements of this section for the content of such 665
766		-	plan, accuracy of reports submitted to the department and the 666
767		-	membership of the hospital staffing committee. In determining whether 667
768		-	to order an audit, the commissioner shall consider whether there has 668
769		-	been consistent noncompliance by the hospital with the nurse staffing 669
770		-	plan, fear of false reporting by the hospital [,] or any other health care 670
771		-	quality safety concerns. The hospital that is subject to the audit shall pay 671
772		-	the cost of the audit. The audit shall not affect the conduct by the 672
773		-	hospital of peer review as defined in section 19a-17b. 673
774		-	Sec. 16. Subsection (a) of section 19a-133c of the 2024 supplement to 674
775		-	the general statutes is repealed and the following is substituted in lieu 675
776		-	thereof (Effective from passage): 676
777		-	(a) As used in this section, "structural racism" means a system that 677
778		-	structures opportunity and assigns value in a way that 678
779		-	disproportionally and negatively impacts Black, Indigenous, Latino or 679
780		-	Asian people or other people of color, and "state agency" has the same 680
781		-	meaning as provided in section 1-79. The Commission on Racial Equity 681
782		-	in Public Health, established under section 19a-133a, shall recommend 682
783		-	best practices for state agencies to (1) evaluate structural racism within 683
784		-	their own policies, practices [,] and operations, and (2) create and 684
785		-	implement a plan, which includes the establishment of benchmarks for 685
786		-	improvement, to ultimately eliminate any such structural racism within 686
787		-	the agency. 687
788		-	Sec. 17. Subdivision (1) of subsection (k) of section 19a-508c of the 688
789		-	2024 supplement to the general statutes is repealed and the following is 689 Substitute Bill No. 5488
790		-
791		-
792		-	LCO 23 of 28
793		-
794		-	substituted in lieu thereof (Effective from passage): 690
795		-	(k) (1) If any transaction described in subsection (c) of section 19a-691
796		-	486i [,] results in the establishment of a hospital-based facility at which 692
797		-	facility fees may be billed, the hospital or health system, that is the 693
798		-	purchaser in such transaction shall, not later than thirty days after such 694
799		-	transaction, provide written notice, by first class mail, of the transaction 695
800		-	to each patient served within the three years preceding the date of the 696
801		-	transaction by the health care facility that has been purchased as part of 697
802		-	such transaction. 698
803		-	Sec. 18. Subdivision (21) of section 20-73e of the 2024 supplement to 699
804		-	the general statutes is repealed and the following is substituted in lieu 700
805		-	thereof (Effective from passage): 701
806		-	(21) "Rule" means a regulation, principle [,] or directive promulgated 702
807		-	by the commission that has the force of law; and 703
808		-	Sec. 19. Subparagraph (B) of subdivision (2) of subsection (b) of 704
809		-	section 20-87a of the 2024 supplement to the general statutes is repealed 705
810		-	and the following is substituted in lieu thereof (Effective from passage): 706
811		-	(B) An advanced practice registered nurse having been issued a 707
812		-	license pursuant to subsection (d) of section 20-94a who collaborated, 708
813		-	prior to the issuance of such license, with a physician licensed to practice 709
814		-	medicine in another state may count the time of such collaboration 710
815		-	toward the three-year requirement set forth in subparagraph (A) of this 711
816		-	[subsection] subdivision, provided such collaboration otherwise 712
817		-	satisfies the requirements set forth in said subparagraph. 713
818		-	Sec. 20. Subsection (d) of section 20-185aa of the 2024 supplement to 714
819		-	the general statutes is repealed and the following is substituted in lieu 715
820		-	thereof (Effective from passage): 716
821		-	(d) Any health care facility that employs or retains a surgical 717
822		-	technologist shall submit to the Department of Public Health, upon 718
823		-	request of the department, documentation [demonstration] 719 Substitute Bill No. 5488
824		-
825		-
826		-	LCO 24 of 28
827		-
828		-	demonstrating that the surgical technologist is in compliance with the 720
829		-	requirements set forth in this section. 721
830		-	Sec. 21. Subsection (b) of section 38a-479jjj of the 2024 supplement to 722
831		-	the general statutes is repealed and the following is substituted in lieu 723
832		-	thereof (Effective from passage): 724
833		-	(b) On and after January 1, 2024, a contract entered into between a 725
834		-	pharmacy [benefit] benefits manager and a 340B covered entity shall not 726
835		-	contain any of the following provisions: 727
836		-	(1) A reimbursement rate for a prescription drug that is less than the 728
837		-	reimbursement rate paid to pharmacies that are not 340B covered 729
838		-	entities; 730
839		-	(2) A fee or adjustment that is not imposed on providers or 731
840		-	pharmacies that are not 340B covered entities; 732
841		-	(3) A fee or adjustment amount that exceeds the fee or adjustment 733
842		-	amount imposed on providers or pharmacies that are not 340B covered 734
843		-	entities; 735
844		-	(4) Any provision that prevents or interferes with a patient's choice 736
845		-	to receive a prescription drug from a 340B covered entity, including the 737
846		-	administration of the drug; and 738
847		-	(5) Any provision that excludes a 340B covered entity from pharmacy 739
848		-	[benefit] benefits manager networks based on the 340B covered entity's 740
849		-	participation in the federal 340B Drug Pricing Program. 741
850		-	Sec. 22. Subsection (d) of section 38a-518v of the 2024 supplement to 742
851		-	the general statutes is repealed and the following is substituted in lieu 743
852		-	thereof (Effective from passage): 744
853		-	(d) Nothing in this section shall prohibit or limit a health insurer, 745
854		-	health care center, hospital service corporation, medical service 746
855		-	corporation or other entity from conducting utilization review for an in-747
856		-	home hospice [services] service, provided such utilization review is 748 Substitute Bill No. 5488
857		-
858		-
859		-	LCO 25 of 28
860		-
861		-	conducted in the same manner and uses the same clinical review criteria 749
862		-	as a utilization review for the same hospice services provided in a 750
863		-	hospital. 751
864		-	Sec. 23. Subsection (c) of section 10-532 of the 2024 supplement to the 752
865		-	general statutes is repealed and the following is substituted in lieu 753
866		-	thereof (Effective October 1, 2024): 754
867		-	(c) When developing the program, said commissioners and executive 755
868		-	director [,] shall (1) consult with insurers that offer health benefit plans 756
869		-	in the state, hospitals, local public health authorities, existing early 757
870		-	childhood home visiting programs, community-based organizations 758
871		-	and social service providers; and (2) maximize the use of available 759
872		-	federal funding. 760
873		-	Sec. 24. Subsection (g) of section 19a-59j of the 2024 supplement to the 761
874		-	general statutes is repealed and the following is substituted in lieu 762
875		-	thereof (Effective October 1, 2024): 763
876		-	(g) Notwithstanding any provision of the general statutes, the 764
877		-	commissioner, or the commissioner's designee, may provide the infant 765
878		-	mortality review committee, established pursuant to section 19a-59k, 766
879		-	with information as is necessary, in the commissioner's discretion, for 767
880		-	the committee to make recommendations regarding the prevention of 768
881		-	infant deaths. 769
882		-	Sec. 25. Subdivision (3) of section 19a-111b of the 2024 supplement to 770
883		-	the general statutes is repealed and the following is substituted in lieu 771
884		-	thereof (Effective October 1, 2024): 772
885		-	(3) The commissioner shall establish a program for the detection of 773
886		-	sources of lead poisoning. Within available appropriations, such 774
887		-	program shall include the identification of dwellings in which paint, 775
888		-	plaster or other accessible substances contain toxic levels of lead and the 776
889		-	inspection of areas surrounding such dwellings for lead-containing 777
890		-	materials. Any person who detects a toxic level of lead, as defined by 778
891		-	the commissioner, shall report such findings to the commissioner. The 779 Substitute Bill No. 5488
892		-
893		-
894		-	LCO 26 of 28
895		-
896		-	commissioner shall inform all interested parties, including, but not 780
897		-	limited to, the owner of the building, the occupants of the building, 781
898		-	enforcement officials and other necessary parties. 782
899		-	Sec. 26. Subsection (l) of section 19a-490 of the 2024 supplement to the 783
900		-	general statutes is repealed and the following is substituted in lieu 784
901		-	thereof (Effective October 1, 2024): 785
902		-	(l) "Assisted living services agency" means an agency that provides 786
903		-	chronic and stable individuals with services that include, but need not 787
904		-	be limited to, nursing services and assistance with activities of daily 788
905		-	living and may have a dementia special care unit or program as defined 789
906		-	in section 19a-562; 790
907		-	Sec. 27. Subdivisions (2) and (3) of subsection (b) of section 19a-181 of 791
908		-	the 2024 supplement to the general statutes are repealed and the 792
909		-	following is substituted in lieu thereof (Effective October 1, 2024): 793
910		-	(2) Each authorized emergency medical [service] services vehicle 794
911		-	shall be equipped with the equipment required for its specific vehicle 795
912		-	classification as specified in the 2022 Connecticut EMS Minimum 796
913		-	Equipment Checklist, as amended from time to time; and 797
914		-	(3) Each authorized emergency medical [service] services vehicle 798
915		-	shall comply with all state and federal safety, design and equipment 799
916		-	requirements. 800
917		-	Sec. 28. Subdivision (9) of subsection (c) of section 19a-493 of the 2024 801
918		-	supplement to the general statutes is repealed and the following is 802
919		-	substituted in lieu thereof (Effective October 1, 2024): 803
920		-	(9) The provisions of this subsection shall not apply in the event of a 804
921		-	change of ownership or beneficial ownership of ten per cent or less of 805
922		-	the ownership of a licensed outpatient surgical facility, as defined in 806
923		-	section 19a-493b, resulting in a transfer to a physician licensed under 807
924		-	chapter 370 if such facility provides information, in a form and manner 808
925		-	prescribed by the commissioner, to update such facility's licensing 809 Substitute Bill No. 5488
926		-
927		-
928		-	LCO 27 of 28
929		-
930		-	information. 810
931		-	Sec. 29. Subdivision (2) of subsection (c) of section 19a-566 of the 2024 811
932		-	supplement to the general statutes is repealed and the following is 812
933		-	substituted in lieu thereof (Effective October 1, 2024): 813
934		-	(2) If a patient receiving birth center services no longer presents with 814
935		-	a low-risk pregnancy, as defined in section 19a-490, as amended by this 815
936		-	act, or otherwise fails to meet the patient eligibility criteria described in 816
937		-	subparagraph (A) of subdivision (1) of this subsection, the birth center 817
938		-	providing such services shall ensure the patient's care is transferred to a 818
939		-	licensed health care provider capable of providing the appropriate level 819
940		-	of obstetrical care for the patient. 820
941		-	Sec. 30. (Effective from passage) The Commissioner of Public Health 821
942		-	shall conduct a scope of practice review pursuant to sections 19a-16d to 822
943		-	19a-16f, inclusive, of the general statutes, to determine whether 823
944		-	naturopathic physicians licensed pursuant to chapter 373 of the general 824
945		-	statutes should be permitted to prescribe, dispense and administer 825
946		-	prescription medication and, if so, whether the Department of Public 826
947		-	Health should (1) establish educational and examination requirements 827
948		-	or other qualifications to permit a naturopathic physician to prescribe, 828
949		-	dispense and administer prescription medication, or (2) develop a 829
950		-	naturopathic formulary of prescription medication that a naturopathic 830
951		-	physician who meets such educational and examination requirements 831
952		-	or other qualifications may use. Not later than January 1, 2025, the 832
953		-	commissioner shall report, in accordance with the provisions of section 833
954		-	11-4a of the general statutes, the findings of such review and any 834
955		-	recommendations to the joint standing committee of the General 835
956		-	Assembly having cognizance of matters relating to public health. 836
	592	+	(3) Each authorized emergency medical [service] services vehicle 489
	593	+	shall comply with all state and federal safety, design and equipment 490
	594	+	requirements. 491
	595	+	Sec. 29. Subdivision (9) of subsection (c) of section 19a-493 of the 2024 492
	596	+	supplement to the general statutes is repealed and the following is 493
	597	+	substituted in lieu thereof (Effective October 1, 2024): 494
	598	+	(9) The provisions of this subsection shall not apply in the event of a 495
	599	+	change of ownership or beneficial ownership of ten per cent or less of 496
	600	+	the ownership of a licensed outpatient surgical facility, as defined in 497
	601	+	section 19a-493b, resulting in a transfer to a physician licensed under 498
	602	+	chapter 370 if such facility provides information, in a form and manner 499
	603	+	prescribed by the commissioner, to update such facility's licensing 500
	604	+	information. 501
	605	+	Sec. 30. Subdivision (2) of subsection (c) of section 19a-566 of the 2024 502
	606	+	supplement to the general statutes is repealed and the following is 503
	607	+	substituted in lieu thereof (Effective October 1, 2024): 504
	608	+	(2) If a patient receiving birth center services no longer presents with 505
	609	+	a low-risk pregnancy, as defined in section 19a-490, as amended by this 506
	610	+	act, or otherwise fails to meet the patient eligibility criteria described in 507
	611	+	subparagraph (A) of subdivision (1) of this subsection, the birth center 508
	612	+	providing such services shall ensure the patient's care is transferred to a 509
	613	+	licensed health care provider capable of providing the appropriate level 510
	614	+	of obstetrical care for the patient. 511
957	615		This act shall take effect as follows and shall amend the following
958	616		sections:
959	617
960	618		Section 1 from passage 19a-6s
961	619		Sec. 2 October 1, 2024 19a-127n(b)
962		-	Sec. 3 October 1, 2024 19a-197a Substitute Bill No. 5488
963		-
964		-
965		-	LCO 28 of 28
966		-
	620	+	Sec. 3 October 1, 2024 19a-197a
967	621		Sec. 4 July 1, 2024 20-195c(a)
968	622		Sec. 5 October 1, 2024 19a-508c(l)(3)
969	623		Sec. 6 October 1, 2024 20-7f
970		-	Sec. 7 from passage New section
	624	+	Sec. 7 from passage New section Raised Bill No. 5488
	625	+
	626	+
	627	+
	628	+	LCO No. 2753 18 of 18
	629	+
971	630		Sec. 8 from passage 20-195n(b)
972	631		Sec. 9 October 1, 2024 20-252
973	632		Sec. 10 October 1, 2024 20-12i
974		-	Sec. 11 October 1, 2024 19a-508c
975		-	Sec. 12 ~~from passage 17a-673c~~(d)
976		-	Sec. 13 from passage 17a-~~674h~~(c)
977		-	Sec. 14 from passage ~~19a-77~~(~~a)(5~~)
978		-	Sec. 15 from passage 19a-~~89e~~(q)
979		-	Sec. 16 from passage 19a-~~133c~~(a)
980		-	Sec. 17 from passage 19a-~~508c~~(~~k)(1~~)
981		-	Sec. 18 from passage ~~20-73e~~(21)
982		-	Sec. 19 from passage 20-~~87a~~(~~b)(2)(B~~)
983		-	Sec. 20 from passage 20-~~185aa~~(d)
984		-	Sec. 21 from passage ~~38a-479jjj~~(b)
985		-	Sec. 22 from passage 38a-~~518v~~(d)
986		-	Sec. 23 ~~October 1,~~ ~~2024 10-532~~(c)
987		-	Sec. 24 October 1, 2024 ~~19a-59j~~(g)
988		-	Sec. 25 October 1, 2024 19a-~~111b~~(3)
989		-	Sec. 26 October 1, 2024 19a-~~490~~(l)
990		-	Sec. 27 October 1, 2024 19a-~~181~~(~~b)(2~~) ~~and (3)~~
991		-	Sec. 28 October 1, 2024 19a-~~493~~(c)(9)
992		-	Sec. 29 October 1, 2024 19a-~~566~~(c)(2)
993		-	Sec. 30 ~~from passage New section~~
	633	+	Sec. 11 October 1, 2024 19a-508c(b)
	634	+	Sec. 12 October 1, 2024 19a-508c(l)(1)
	635	+	Sec. 13 from passage 17a-673c(d)
	636	+	Sec. 14 from passage 17a-674h(c)
	637	+	Sec. 15 from passage 19a-77(a)(5)
	638	+	Sec. 16 from passage 19a-89e(q)
	639	+	Sec. 17 from passage 19a-133c(a)
	640	+	Sec. 18 from passage 19a-508c(k)(1)
	641	+	Sec. 19 from passage 20-73e(21)
	642	+	Sec. 20 from passage 20-87a(b)(2)(B)
	643	+	Sec. 21 from passage 20-185aa(d)
	644	+	Sec. 22 from passage 38a-479jjj(b)
	645	+	Sec. 23 from passage 38a-518v(d)
	646	+	Sec. 24 October 1, 2024 10-532(c)
	647	+	Sec. 25 October 1, 2024 19a-59j(g)
	648	+	Sec. 26 October 1, 2024 19a-111b(3)
	649	+	Sec. 27 October 1, 2024 19a-490(l)
	650	+	Sec. 28 October 1, 2024 19a-181(b)(2) and (3)
	651	+	Sec. 29 October 1, 2024 19a-493(c)(9)
	652	+	Sec. 30 October 1, 2024 19a-566(c)(2)
994	653
995		-	PH Joint Favorable Subst.
	654	+	Statement of Purpose:
	655	+	To make various revisions to the public health statutes.
	656	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	657	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	658	+	underlined.]
996	659