CT SB00342

Requires insurers to reimburse health care providers at equal rates for outpatient services (using CPT E/M, CPT A/M, telehealth, or drug infusion codes) regardless of facility location, effective July 1, 2026

Prohibits health carriers from using artificial intelligence, algorithms, or other software tools to automatically downcode or deny insurance claims without review by a clinical peer, effective October 1, 2026

Expands step therapy exemptions to cover all disabling or life-threatening chronic diseases (previously limited to stage IV metastatic cancer, multiple sclerosis, and rheumatoid arthritis), and caps step therapy duration at 30 days for any prescribed drug

Creates a rebuttable presumption that health care services ordered by providers in the highest tier of a carrier's network are medically necessary, shifting the burden to insurers to prove otherwise, effective January 1, 2027

Extends contract continuation requirements when health carrier-hospital contracts are terminated or not renewed, requiring both parties to abide by existing terms until the dispute is resolved or the policyholder's renewal date (previously 60 days)