SB 1048 Summary

• Requires insurers, health care centers, hospital service corporations, medical service corporations, and preferred provider networks to include specific reimbursement provisions in contracts with health care providers entered into, renewed, or amended on or after July 1, 2022.

• Mandates reimbursement for covered outpatient benefits using CPT evaluation and management codes, CPT assessment and management codes, or drug infusion codes in amounts that do not vary based on the facility where the benefit is provided.

• Requires equal reimbursement rates for all contracting health care providers in the same geographic region (as determined by the Insurance Commissioner) regardless of employer or affiliation when reimbursement is made on a fee-for-benefit basis or bundled benefits basis.

• Requires contracts to include a conspicuous statement confirming compliance with these reimbursement provisions.

• Directs the Insurance Commissioner to adopt regulations implementing these provisions in accordance with Connecticut General Statutes chapter 54; effective date is July 1, 2022.