CT HB05235

Requires insurers, health care centers, hospitals, and medical service corporations to complete coverage determinations and notify insureds or their health care providers within 45 days of receiving a request for determination.

Mandates that entities denying coverage provide written reasons for the denial to both the insured and the insured's health care provider.

Requires entities to notify insureds of the right to contact the Office of the Healthcare Advocate if they believe they received erroneous information when a denial is based on medical necessity or coverage status.

Requires entities to provide contact information for the Office of the Healthcare Advocate with all denials citing medical necessity or coverage exclusions.

Applies to individual and group health insurance policies delivering coverage under specified categories, effective January 1, 2011.