Proposed S.B. No. 87
Session Year 2023

AN ACT CONCERNING ADVERSE DETERMINATION AND UTILIZATION REVIEWS.

To: (1) Redefine "clinical peer" for the purposes of adverse determination and utilization reviews; (2) require health carriers to bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; and (3) require health carriers to provide certain clinical peers with authority to reverse initial adverse determinations.

Other Bills with Similar Topics

  Utilization review 

 

• SB00006 - AN ACT CONCERNING UTILIZATION REVIEW AND HEALTH CARE CONTRACTS, HEALTH INSURANCE COVERAGE FOR NEWBORNS AND STEP THERAPY.
• SB00028 - AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION AND UTILIZATION REVIEWS.

  Health insurance claims denials 

 

• HB05453 - AN ACT PROHIBITING HEALTH CARE INSURERS FROM RETROACTIVELY DENYING HEALTH INSURANCE CLAIMS FOR BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES.
• SB00028 - AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION AND UTILIZATION REVIEWS.
• SB01082 - AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE DEPARTMENT OF TRANSPORTATION REGARDING A REDUCTION IN BLOOD ALCOHOL LIMITS FOR IMPAIRED DRIVING AND BOATING.