Connecticut 2022 Regular Session Status: In Committee 2 D cosponsors

SB 15 — AN ACT ENCOURAGING PRIMARY AND PREVENTIVE CARE.

Last action — FILE NO. 39

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  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 2022 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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

239 added · 186 removed

239 line(s) added, 186 removed.

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General Assembly Governor's Bill No.
Senate General Assembly File No.
15 February Session, 2022 LCO No.
39 February Session, 2022 Substitute Senate Bill No.
728 Referred to Committee on INSURANCE AND REAL ESTATE Introduced by:
15 Senate, March 21, 2022 The Committee on Insurance and Real Estate reported through SEN.
Request of the Governor Pursuant to Joint Rule 9 AN ACT ENCOURAGING PRIMARY AND PREVENTIVE CARE.
LESSER of the 9th Dist., Chairperson of the Committee on the part of the Senate, that the substitute bill ought to pass.
AN ACT ENCOURAGING PRIMARY AND PREVENTIVE CARE.
(1) "Health carrier" has the same meaning as provided in section 38a- 1080.
(1) "Health carrier" has the same meaning as provided in section 38a- 1080;
[;
and (2) "Third-party administrator" has the same meaning as provided in section 38a-720.
and] (2) "Third-party administrator" has the same meaning as provided in section 38a-720.
(3) "Primary care provider" means a health care provider who (A) (i) is an advanced practice registered nurse licensed pursuant to chapter 378, or (ii) is a physician or physician assistant licensed pursuant to chapter 370, and (B) provides primary care services while acting within such provider's scope of practice.
LCO No.
728 1 of 7 Governor's Bill No.15 (4) (A) "Primary care services" means the following health care services when provided by a primary care provider practicing in the medical field of family medicine, general pediatrics, primary care or internal medicine, without regard to board certification(i) Administration and interpretation of health risk assessments, (ii) behavioral health risk assessments, screening and counseling, (iii) general medical exams, (iv) hospice care, (v) immunizations, (vi) office and home visits, (vii) preventative medicine evaluation and counseling, (viii) routine adult medical and child health exams, and (ix) telehealth visits.
(B) "Primary care services" does not include:
(i) Emergency department care, (ii) inpatient care, (iii) minor outpatient procedures, (iv) nursing facility care, (v) routine primary care or gynecologic services, other than specialized gynecologic services, provided by an obstetrician-gynecologist or midwife, or (vi) practice-administered pharmacy.
[Such statement shall be prominently displayed on such card in a readily understandable, standardized form prescribed by the Insurance Commissioner.] (c) The Insurance Commissioner may adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of this section.
Such statement shall be prominently displayed on such sSB15 / File No.
(d) Each health carrier or third-party administrator that issues a card to an individual in this state for the purpose of enabling such individual to prove that such individual has health coverage shall include the following information on such card, in addition to the information provided in subsection (b) of this section:
39 1 sSB15 File No.
(1) The name of, and contact information for, an in-network primary LCO No.
39 card in a readily understandable, standardized form prescribed by the Insurance Commissioner.
728 2 of 7 Governor's Bill No.15 care provider whom the individual has designated to serve as such individual's preferred primary care provider;
(c) The Insurance Commissioner may adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of this section.
or (2) If the individual has not designated a preferred primary care provider under subdivision (1) of this subsection, the telephone number for a hotline maintained by such health carrier or third-party administrator for the purpose of providing such individual with a list of local in-network primary care providers accepting new patients, or the address of an Internet web site maintained by such health carrier or third-party administrator for the purpose of enabling such individual to contact, andschedule appointmentswith, localin-network primary care providers.
(d) Each health carrier or third-party administrator that issues a card to an individual in this state for the purpose of enabling such individual to prove that such individual has health coverage shall prominently display the following information on such card in a readily understandable manner, in addition to the information provided in subsection (b) of this section:
(e) Each health carrier or third-party administrator that issues a card to an individual in this state for the purpose of enabling such individual to prove that such individual has health coverage shall include on such card, in addition to the information prescribed by subsections (b) and (d) of this section, telehealth network contact information for such health carrier or third-party administrator.
(1) The name of, and contact information for, an in-network primary care provider whom the individual has designated to serve as such individual's preferred primary care provider;
(f) The information required to be included under subsections (b), (d) and (e) of this section shall be prominently displayed on each card in a readily understandable, standardized form prescribed by the Insurance Commissioner.
or (2) If the individual has not designated a preferred primary care provider under subdivision (1) of this subsection, a telephone number maintained by such health carrier or third-party administrator for the purpose of assisting such individual with accessing telehealth or a list of local in-network primary care providers accepting new patients, or the address of an Internet web site maintained by such health carrier or third-party administrator for the purpose of enabling such individual to contact, andschedule appointmentswith,localin-network primary care providers, unless such health carrier or third-party administrator issues a separate card to an individual for purposes of such services.
(g) The information required to be included on each card under subsections (b), (d) and (e) of this section may also be made available in electronic format by the health carrier or third-party administrator, if requested by the insured member.
(e) The information required to be included on each card under subsection (d) of this section may alternatively be made available in electronic card format by the health carrier or third-party administrator, if requested by the insured member.
Any member who has requested an electronic card may also receive such card in hard copy via mail.
Any member who requests an electronic card may also receive such card in hard copy via mail.
(NEW) (Effective January 1, 2024) (a) (1) For the purposes of this section, "chronic disease" means coronary artery disease, diabetes, hyperlipidemia or hypertension.
(NEW) (Effective January 1, 2023) (a) (1) For the purposes of this section, "chronic disease" means coronary artery disease, diabetes, sSB15 / File No.
(2) "Health enhancement program" means a health benefit program that ensures access and removes barriers to essential, high-value clinical LCO No.
39 2 sSB15 File No.
728 3 of 7 Governor's Bill No15 services.
39 hyperlipidemia or hypertension.
(2) "Health enhancement program" means a health benefit program that ensures access and removes barriers to essential, high-value clinical services.
(B) Provide to each insured under the individual or group health insurance policy incentives that are directly related to the provision of health insurance coverage;
and (B) Provide to each insured under the individual or group health insurance policy incentives that are directly related to the provision of health insurance coverage, provided such insured chooses to complete certain preventive examinations and screenings recommended by the United States Preventive Services Task Force with a rating of "A" or "B".
and (C) Require each insured under the individual or group health insurancepolicytoundergopreventiveexaminationsandscreeningsfor chronic diseases recommended by the United States Preventive Services Task Force with a rating of "A" or "B".
(3) No health enhancement program developed pursuant to subdivision (1) of this subsection shall impose any penalty or other negative incentive on an insured under the individual or group health insurance policy nor shall any insured be required to participate in a health enhancement program.
(3) No health enhancement program developed pursuant to subdivision (1) of this subsection shall impose any penalty or other negative incentive on an insured under the individual or group health insurance policy.
(c) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 ofthegeneralstatutesdelivered,issuedfor delivery,renewed,amended or continued in this state shall include coverage for the health enhancement programs that the insurer, health care center, hospital sSB15 / File No.
(c) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 ofthegeneralstatutesdelivered,issuedfor delivery,renewed,amended or continued in this state shall include coverage for the health enhancement programs that the insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit LCO No.
39 3 sSB15 File No.
728 4 of 7 Governor's Bill No15 society or other entity that delivered, issued, renewed, amended or continued such policy developed pursuant to this section.
39 service corporation, medical service corporation, fraternal benefit society or other entity that delivered, issued, renewed, amended or continued such policy developed pursuant to this section.
(1) "Department" means the Department of Social Services.
(1) "Department" means the Department of Social Services;
(2) "Connecticut medical assistance program" means the state's Medicaid program and the Children's Health Insurance program administered by the Department of Social Services.
and (2) "Connecticut medical assistance program" means the state's Medicaid program and the Children's Health Insurance program administered by the Department of Social Services.
(3) "Primary care provider" means a health care provider who (A) (i) is an advanced practice registered nurse licensed pursuant to chapter 378 of the general statutes, or (ii) is a physician or physician assistant licensedpursuanttochapter370ofthegeneralstatutes,and(B)provides primary care services while acting within such provider's scope of practice.
(4) (A) "Primary care services" means the following health care services when provided by a primary care provider practicing in the medical field of family medicine, general pediatrics, primary care or internal medicine, without regard to board certification:(i) Administration and interpretation of health risk assessments, (ii) LCO No.
728 5 of 7 Governor's Bill No15 behavioral health risk assessments, screening and counseling, (iii) general medical exams, (iv) hospice care, (v) immunizations, (vi) office and home visits, (vii) preventative medicine evaluation and counseling, (viii) routine adult medical and child health exams, and (ix) telehealth visits.
(B) "Primary care services" does not include:
(i) Emergency department care, (ii) inpatient care, (iii) minor outpatient procedures, (iv) nursing facility care, (v) routine primary care or gynecologic services, other than specialized gynecologic services, provided by an obstetrician-gynecologist or midwife, or (vi) practice-administered pharmacy.
(1) The name of, and contact information for, a primary care provider enrolled in the Connecticut medical assistance program whom the individual has designated to serve as such individual's preferred primary care provider, or the primary care provider whom the department or its agent has identified as the primary care provider to whom the individual has been attributed based on analysis of available health care claims information for the individual;
(1) The name of, and contact information for, a primary care provider enrolled in the Connecticut medical assistance program whom the individual has designated to serve as such individual's preferred primary care provider, or the primary care provider whom the department or its agent has identified as the primary care provider to sSB15 / File No.
or (2) If the individual has not designated a preferred primary care provider under subdivision (1) of this subsection and the department was not able to attribute the individual to a primary care provider based on available health care claims information for the individual, the department shall include on such card a notation to contact the department's agent, with available contact information or a reference to such agent, for assistance with finding, contacting and scheduling appointments with primary care providers enrolled in the Connecticut LCO No.
39 4 sSB15 File No.
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728 6 of 7 Governor's Bill No.
39 whom the individual has been attributed based on analysis of available health care claims information for the individual;
15 medical assistance program.
or (2) If the individual has not designated a preferred primary care provider under subdivision (1) of this subsection and the department is not able to attribute the individual to a primary care provider based on available health care claims information for the individual, the department shall include on such card a notation to contact the department's agent, with available contact information or a reference to such agent, for assistance with finding, contacting and scheduling appointments with primary care providers enrolled in the Connecticut medical assistance program.
2 January 1, 2024 New section Sec.
2 January 1, 2023 New section Sec.
3 January 1, 2024 New section Statement of Purpose:
3 January 1, 2024 New section INS Joint Favorable Subst.
To implement the Governor's budget recommendations.
sSB15 / File No.
[Proposed deletions are enclosed in brackets.
39 5 sSB15 File No.
Proposed additions are indicated by underline, except underlined.]e entire text of a bill or resolution or a section of a bill or resolution is new, it is not LCO No.
39 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.
728 7 of 7
In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.
Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
OFA Fiscal Note State Impact:
None Municipal Impact:
See below Explanation The bill, which requires private health carriers in Connecticut to develop at least two health enhancement programs (HEPs) under their policies and to display certain informationonhealth insurance ID cards, does not result in a fiscal impact to the state.
It is anticipated that the Insurance Department, which may adopt implementing regulations under the bill, can review compliance within existing resources.
It is unknown if there will be a fiscal impact to fully insured municipalities as a result of HEP provisions of the bill.
The bill also requires the Department of Social Services (DSS) to print certain information on medical assistance program ID cards, which is not anticipated to result in a fiscal impact as it applies to cards issued on and after January 1, 2024.
The Out Years State Impact:
None Municipal Impact:
Unknown sSB15 / File No.
39 6 sSB15 File No.
39 OLR Bill Analysis sSB 15 AN ACT ENCOURAGING PRIMARY AND PREVENTIVE CARE.
SUMMARY This bill requires health carriers (e.g., insurers and HMOs) that deliver, issue, renew, amend, or continue certain individual or group health insurance policies in the state to develop at least two health enhancement programs (HEPs) under the policies by January 1, 2024.
The bill defines a HEP as a health benefit program that ensures access and removes barriers to essential, high-value clinical services.
The bill authorizes the insurance commissioner to adopt implementing regulations.
The bill also requires health carriers and third-party administrators (TPAs) that issue health insurance identification (ID) cards to insureds to prominently display on them, in a readily understandable manner, information to assist the insured with accessing and contacting a primary care provider (PCP).
Lastly, the bill requires the Department of Social Services (DSS), on any ID card it issues to an individual who is eligible for the state’s medical assistance program (i.e., Medicaid or HUSKY B), to include information about accessing and contacting a PCP.
EFFECTIVE DATE:
January 1, 2023, except the provisions about ID cards are effective January 1, 2024.
HEALTH ENHANCEMENT PROGRAMS The bill requires health carriers to develop at least two HEPs by January 1, 2024.
Each HEP must (1) be available to each insured under the health insurance policy and (2) provide incentives to each insured directly related to providing health insurance coverage for insureds sSB15 / File No.
39 7 sSB15 File No.
39 choosing to complete certain preventive examinations and screenings the U.S.
Preventive Services Task Force recommends with an “A” or“B” rating.
(Presumably, the bill means to limit this to chronic diseases as defined in the bill (i.e., coronary artery disease, diabetes, hyperlipidemia, or hypertension).
However, while the bill defines “chronic disease,” it does not otherwise use the term.) The bill prohibits a HEP from imposing any penalty or negative incentive on an insured.
It also specifies that an insured cannot be required to participate in a HEP.
The bill also requires certain individual and group health insurance policies to cover the HEPs.
However, it is unclear if this means they must cover HEP administration costs or the examinations and screenings insureds receive through the HEP.
The bill’s HEP provisions apply to individual and group health insurance policies delivered, issued, renewed, amended, or continued in Connecticut that cover (1) basic hospital expenses;
(2) basic medical- surgical expenses;
(3) major medical expenses;
or (4) hospital or medical services, including those provided under an HMO plan.
HEALTH INSURANCE ID CARDS Under the bill, health carriers and TPAs that issue health insurance ID cards must include on an insured’s ID card the name and contact information for an in-network PCP whom the insured designated as his or her preferred PCP.
If the insured did not designate a PCP, the carrier or TPA must instead include on the ID card (1) a telephone number the insured may call to access telehealth or a list of local in-network PCPs accepting new patients or (2) the website address that allows the insured to contact and schedule appointments with local in-network PCPs, unless the carrier or TPA issues a separate card for these purposes.
The bill allows carriers and TPAs to provide the above information in an electronic card to an insured who requests it in that format.
sSB15 / File No.
39 8 sSB15 File No.
39 Anyone who receives an electronic card may also receive a hard copy ID card in the mail.
By law, the insurance commissioner may adopt implementing regulations for ID cards.
MEDICAL ASSISTANCE PROGRAM ID CARDS The bill requires DSS to include on its medical assistance program ID cards, to the extent available when issuing the card, the name and contact information for a PCP enrolled in the program whom (1) the covered individual designated as his or her preferred PCP or (2) DSS has identified based on the individual’s health care claims.
If the individual did not designate a PCP, andDSS could not attribute the individual to one based on health care claims data, then DSS must instead include on the ID card a note to contact a DSS agent.
The note must contain the agent’s contact information for help finding, contacting, and scheduling appointments with PCPs enrolled in the medical assistance program.
COMMITTEE ACTION Insurance and Real Estate Committee Joint Favorable Substitute Yea 17 Nay 0 (03/10/2022) sSB15 / File No.
39 9
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Action History

  1. FILE NO. 39

  2. SENATE CALENDAR NUMBER 69

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

  4. RPTD. OUT OF LCO

  5. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 03/21/22

  6. FILED WITH LCO

  7. Joint Favorable Substitute

  8. PUBLIC HEARING 0301

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

Sponsors

Sponsorship breakdown

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2 sponsors · 0 co-sponsors · 185 not signed on

Sponsors (2)

Co-sponsors (0)

None.

Not signed on (185)

185 members have not signed on to this bill.

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"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.

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Frequently asked questions

Who sponsors SB 15?
SB 15 is sponsored by Travis Simms (Democratic) and Saud Anwar (Democratic).
What is the current status of SB 15?
This bill died with 2022 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 15?
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