CT SB00297

Requires all health insurance entities (insurance companies, hospital service corporations, medical service corporations, health care centers, and fraternal benefit societies) to cover in-network health care services for both individual and group health insurance policies, effective January 1, 2019.

Allows insurers to seek recovery from insured or enrollee for costs of non-medically necessary services, but limits recovery amounts to the Medicare reimbursement rate for those services.

Permits continued utilization review practices by insurers as defined in section 38a-591a of the general statutes.

Modifies the definition of "clinical peer" to include physicians and other health care professionals with appropriate board certifications and training in substance use disorder and mental health treatment when reviewing cases involving these conditions.