Connecticut House Bill HB06147

Connecticut 2025 Regular Session

• Introduced: 1/22/25
• Refer: 1/22/25

Caption

An Act Concerning Coverage For Medically Necessary Treatment In This State.

Impact

The legislation mandates that health carriers provide coverage for medical treatments considered life-saving, as recommended by licensed healthcare provider specialists. This requirement seeks to prevent unjust denials of coverage based on outdated or unsupported medical practices. Additionally, the bill revises the review process for adverse determinations, establishing clear deadlines for resolving requests — notably, nonurgent care requests must be settled within ten business days, and urgent requests within forty-eight hours. These changes aim to ensure that patients receive timely care, particularly in critical health situations.

Summary

House Bill 6147, introduced by Representative Allie-Brennan, aims to enhance the standards for insurance coverage concerning medically necessary treatments in Connecticut. The bill proposes that all health carriers must align their coverage guidelines with the most recent evidence-based medical standards, ensuring that patients receive treatments backed by current medical research. One of the key components of this proposal is the requirement for transparency in the claim-review practices undertaken by these health carriers, which would provide patients with greater clarity about their insurance processes.

Contention

While the bill is largely seen as a positive step towards improving healthcare accessibility and standards, some points of contention may arise in how insurance companies implement these requirements. Concerns about potential impacts on insurance premiums and the financial implications for health carriers may be debated. Furthermore, the discussion surrounding what constitutes 'life-saving care' could lead to disagreements among stakeholders, particularly in determining which treatments are covered and how medical evidence is evaluated. Opponents of the bill may argue about the added regulatory burdens on insurance providers and the potential for increased costs that could be passed on to consumers.