HB 5015 Summary

• Repeals and replaces Section 17b-265 of the general statutes effective July 1, 2020, governing Medicaid subrogation and third-party recovery rights.

• Department of Social Services gains subrogation rights to recover medical assistance costs from applicants, recipients, legally liable relatives, and third-party insurers including self-insured plans, group health plans, managed care organizations, and pharmacy/dental benefit managers.

• Establishes a 3-year filing deadline for subrogation claims (from date service was furnished) and a 6-year deadline to enforce collection actions from the date of claim submission.

• Requires insurers and third parties to respond to state Medicaid claims within 90 days with payment, information request, or written denial; failure to respond within 120 days creates an uncontestable obligation to pay the claim.

• Prohibits insurers from denying or limiting coverage based on Medicaid eligibility and prevents imposition of different requirements on the state Medicaid agency compared to other assignees; repeals Section 315 of Public Act 19-117.