CT HB06895

Mandated health benefits passed by the General Assembly on or after January 1, 2026, will automatically terminate four years after their effective date unless the legislature approves them by majority vote following a mandatory review by the Insurance Commissioner

Individual and group health insurance policies must cover biomarker testing (analysis of tissue, blood, or biospecimens for gene mutations or protein expressions) for diagnosis, treatment, and monitoring when supported by FDA approval, Medicare coverage determinations, or nationally recognized clinical practice guidelines

Prior authorization decisions for biomarker testing must be made within 7 days for non-urgent requests and 72 hours for urgent requests, with insurers required to establish clear processes for coverage exceptions and appeals

Bills impacting premiums for health benefit plans offered through the state exchange must include an "enrollee impact statement" prepared by the Office of Fiscal Analysis, similar to existing requirements for fiscal notes and electric ratepayer impact statements

The Insurance Commissioner may engage actuaries, health policy research organizations, and other independent experts to conduct mandated health benefit reviews, replacing the previous arrangement with the UConn Center for Public Health and Health Policy