CT SB00192

Redefines "clinical peer" qualifications for adverse determination reviews conducted by health insurers, effective January 1, 2015

Clinical peers reviewing standard medical cases must hold a nonrestricted state license, possess a doctoral or medical degree, and either have appropriate national board certification or actively practice in the same specialty as the treatment under review

For reviews of child or adolescent substance use disorders or mental disorders, clinical peers must hold a nonrestricted license, doctoral or medical degree, and national board certification in child and adolescent psychiatry or psychology with relevant training or experience

For reviews of adult substance use disorders or mental disorders, clinical peers must hold a nonrestricted license, doctoral or medical degree, and national board certification in psychiatry or psychology with relevant training or experience

Amends section 38a-591a(7) of the Connecticut General Statutes