CT HB06854

Managed care organizations must submit annual reports to the Insurance Commissioner by May 1st including quality assurance plans, complaints data, prior authorization statistics, model contracts, and financial arrangements with providers (effective January 1, 2016).

Managed care organizations must report claims denial data including total claims received, denials, appeals, reversals, and reasons for denials in a format prescribed by the commissioner.

New reporting requirements added for substance use disorder and mental health treatment data, including prevalence estimates by county, number of patients receiving treatment by level of care, treatment lengths, claim expenses, and in-network provider availability.

Health insurers must submit data on benefit requests, utilization review determinations, and external appeals for substance use disorders, co-occurring disorders, and mental disorders, grouped by level of care and age categories (children, young adults, adults).

Insurance Commissioner must develop and distribute an annual "Consumer Report Card on Health Insurance Carriers in Connecticut" by October 15th, including data from all licensed health care centers and the 15 largest licensed health insurers using provider networks, with prominent display on the department's website.