CT SB00023

Repeals and replaces section 38a-472i to establish setting-neutral reimbursement requirements for health insurance contracts with health care providers, effective October 1, 2017.

Requires health insurers, hospital service corporations, medical service corporations, and similar entities to include setting-neutral reimbursement policies in all contracts entered into, renewed, or amended on or after October 1, 2017, based on Medicare Payment Advisory Commission recommendations.

Mandates equal reimbursement regardless of service setting for evaluation and management visits, Group 1 ambulatory payment classification services, and certain ambulatory surgical procedures.

Limits reimbursement differentials for Group 2 ambulatory payment classification services to only the actual cost of packaging ancillary services.

Requires contracts to include a conspicuous statement certifying compliance with setting-neutral reimbursement policies as required by law.