AN ACT CONCERNING STEP THERAPY, ADVERSE DETERMINATION AND UTILIZATION REVIEWS, AND REQUIRED HEALTH INSURANCE COVERAGE FOR CHILDREN, STEPCHILDREN AND OTHER DEPENDENT CHILDREN.
To: (1) Prohibit health carriers from requiring the use of step therapy for drugs prescribed to treat disabling, chronic or life-threatening diseases or conditions; (2) require that health carriers bear the burden of proving that certain health care services under adverse determination or utilization review are not medically necessary; (3) redefine "clinical peer" for the purposes of adverse determination and utilization reviews; (4) require health carriers to provide certain clinical peers with the authority to reverse initial adverse determinations; and (5) allow children, stepchildren and other dependent children to retain health insurance coverage under their parents' insurance policies until the end of the policy year during which they attain the age of twenty-six.
Introduced by:
Sen. Martin M. Looney, 11th Dist.
