HB 5001 – Connecticut

Status: Enacted
Year Introduced: 2022
Link: https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=HB05001&which_year=2022

Broadly expands health insurance and emergency access to DCF-licensed urgent crisis centers services, including by prohibiting balance billing, higher out-of-network billing, and prior authorization. The bill makes it a Connecticut Unfair Trade Practices Act (CUTPA) violation for a health care provider to “balance bill” an insured for covered out-of-network acute inpatient psychiatric services (i.e., bill
more than the collectable cost-sharing under the policy).
The bill also prohibits any health care center (i.e., HMO) provider, agent, trustee, or assignee from requesting any payment from an enrollee for covered out-of-network acute inpatient psychiatric services, presumably excluding allowable cost sharing. It additionally requires all health care center contracts with providers to disclose that doing so
is a CUTPA violation. Temporarily exempts, from CON requirements, increases in the licensed bed capacity of mental health facilities under certain conditions and requires OHS to report on any recommendations for establishing an expedited CON process for mental health facilities. Beginning July 1, 2024, following the sunset of the temporary insurance coverage provisions, the bill permanently requires certain health insurance policies to cover medical advice, diagnosis, care, or treatment provided through telehealth to the same extent that they cover those services when provided in person by a health care provider licensed in Connecticut.

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