Connecticut 2017 Regular Session Status: In Committee

SB 543 — AN ACT CONCERNING HEALTH INSURANCE COVERAGE OF INPATIENT SUBSTANCE ABUSE SERVICES.

Last action — REF. BY SEN. TO COMM. ON Appropriations

Track this bill free

No card. One bill, free forever — alerts when it moves.

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2017 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

10 added · 14 removed

Plain-language change summary

The amendments to SB 543 change the requirement for health insurance policies regarding inpatient substance abuse services. Instead of a minimum duration of fourteen days, the new language allows coverage until an individual’s condition is stabilized, meaning they are not likely to deteriorate during a transfer from an inpatient facility. This change may provide more flexibility in treatment duration based on medical assessments rather than a fixed period. The amendments also clarify that insurance providers can still conduct utilization reviews and seek recovery for costs deemed not medically necessary, capped at the Medicare reimbursement rate.

→
Previous
Latest
General Assembly   Committee Bill No.
General Assembly   Substitute Bill No.
543 January Session, 2017   LCO No.
543 January Session, 2017   *_____SB00543INS___031617____* AN ACT CONCERNING HEALTH INSURANCE COVERAGE OF INPATIENT SUBSTANCE ABUSE SERVICES.
4617   *04617SB00543INS* Referred to Committee on INSURANCE AND REAL ESTATE   Introduced by:
  (INS)   AN ACT CONCERNING HEALTH INSURANCE COVERAGE OF INPATIENT SUBSTANCE ABUSE SERVICES.
(NEW) (Effective January 1, 2018) Each insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues in this state an individual health insurance policy providing coverage of the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 of the general statutes shall provide coverage to an insured or enrollee who has been diagnosed with a substance use disorder, as described in section 17a-458 of the general statutes, for any treatment episode consisting of fourteen days or more of inpatient substance abuse services.
(NEW) (Effective January 1, 2018) (a) Each insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues in this state an individual health insurance policy providing coverage of the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 of the general statutes that provides coverage to an insured or enrollee who has been diagnosed with a substance use disorder, as described in section 17a-458 of the general statutes, shall cover inpatient substance abuse services provided to the insured or enrollee until such time as the health condition of the insured or enrollee has been stabilized.
For the purposes of this section, "stabilized" means, with respect to an insured or enrollee receiving substance abuse services described in this subsection, that no material deterioration in the health condition of the insured or enrollee is likely, within reasonable medical probability, to result from or occur during the transfer of the insured or enrollee from an inpatient facility.
(b) Nothing in this section shall be construed to prohibit utilization review.
(c) Any insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity providing coverage for the substance abuse services described in subsection (a) of this section may seek recovery from an insured or enrollee for the cost of such services if such services are not medically necessary, provided the amount of such recovery shall not exceed the Medicare reimbursement rate for such services.
For the purposes of this subsection, "medically necessary" has the same meaning as provided in section 38a-482a of the general statutes.
(NEW) (Effective January 1, 2018) Each insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues in this state a group health insurance policy providing coverage of the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 of the general statutes shall provide coverage to an insured or enrollee who has been diagnosed with a substance use disorder, as described in section 17a-458 of the general statutes, for any treatment episode consisting of fourteen days or more of inpatient substance abuse services.
(NEW) (Effective January 1, 2018) (a) Each insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues in this state a group health insurance policy providing coverage of the type specified in subdivision (1), (2), (4), (11) or (12) of section 38a-469 of the general statutes that provides coverage to an insured or enrollee who has been diagnosed with a substance use disorder, as described in section 17a-458 of the general statutes, shall cover inpatient substance abuse services provided to the insured or enrollee until such time as the health condition of the insured or enrollee has been stabilized.
For the purposes of this section, "stabilized" means, with respect to an insured or enrollee receiving substance abuse services described in this subsection, that no material deterioration in the health condition of the insured or enrollee is likely, within reasonable medical probability, to result from or occur during the transfer of the insured or enrollee from an inpatient facility.
(b) Nothing in this section shall be construed to prohibit utilization review.
(c) Any insurance company, hospital service corporation, medical service corporation, health care center, fraternal benefit society or other entity providing coverage for the substance abuse services described in subsection (a) of this section may seek recovery from an insured or enrollee for the cost of such services if such services are not medically necessary, provided the amount of such recovery shall not exceed the Medicare reimbursement rate for such services.
For the purposes of this subsection, "medically necessary" has the same meaning as provided in section 38a-513c of the general statutes.
2 January 1, 2018 New section Statement of Purpose:
2 January 1, 2018 New section INS Joint Favorable Subst.
To require health insurance policies to provide coverage for inpatient substance abuse services with a duration of not less than fourteen days.
[Proposed deletions are enclosed in brackets.
Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.] Co-Sponsors:
SEN.
SOMERS, 18th Dist.
S.B.
543
⬇ Download PDF
View plain text versions (3)
  • R02 html
  • R01 html
  • R00 Current html

Action History

  1. REF. BY SEN. TO COMM. ON Appropriations

  2. FILE NO. 300

  3. SENATE CALENDAR NUMBER 168

  4. FAV. RPT., TAB. FOR CAL., SEN.

  5. RPTD. OUT OF LCO

  6. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 03/28/17

  7. FILED WITH LCO

  8. Joint Favorable Substitute

  9. Vote to Hold until next meeting

  10. Vote to Hold until next meeting

  11. REF. TO JOINT COMM. ON Insurance and Real Estate

  12. DRAFTED BY COMMITTEE

  13. Vote to Draft

  14. PUBLIC HEARING 0207

  15. Reserved for Subject Matter Public Hearing

  16. REF. TO JOINT COMM. ON Insurance and Real Estate

Sponsors

  • Diana S.' b'Urban · Primary
  • Heather B.' b'Somers · Primary
  • Len' b'Suzio · Primary

Sponsorship breakdown

Export CSV (upgrade) →

3 sponsors · 0 co-sponsors · 184 not signed on

Sponsors (3)

  • b'Urban, Diana S.'
  • b'Somers, Heather B.'
  • b'Suzio, Len'

Co-sponsors (0)

None.

Not signed on (184)

184 members have not signed on to this bill.

Show all 184 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 543?
SB 543 is sponsored by b'Urban, Diana S.', b'Somers, Heather B.', and b'Suzio, Len'.
What is the current status of SB 543?
This bill died with 2017 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 543?
Track SB 543 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on SB 543

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of SB 543

Last checked for changes 2 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →