CT SB00360

Utilization review companies must be licensed by the commissioner to conduct reviews in Connecticut for health benefit plans, with licenses renewed every two years instead of annually effective January 1, 2023.

License fee increased from three thousand dollars to six thousand dollars, dedicated to regulating utilization review and implementing related provisions, with funds also available for contracting with University of Connecticut School of Medicine for medical consultations.

Licensure requests must include company name, address, telephone number, business hours, and contact person information, with material changes to policies, procedures, sample letters, or behavioral health clinical criteria reported to the commissioner within thirty calendar days.

Commissioner must receive, investigate, code, track, and review all grievances filed against utilization review companies by covered persons, with authority to impose penalties under section 38a-591k.

Covered persons or their authorized representatives are responsible for requesting certification and authorizing information release from treating health care professionals, with utilization review companies required to permit their participation in this process.