HB 361 Summary

• Prohibits health insurers, health insuring corporations, sickness and accident insurers, multiple employer welfare arrangements, and public employee benefit plans from excluding coverage for services related to acquired brain injuries, including cognitive rehabilitation, neurofeedback therapy, remediation, post-acute rehabilitation, and community reintegration services.

• Requires coverage of reasonable expenses for periodic reevaluation of care for individuals with acquired brain injuries who were previously unresponsive to treatment but become responsive later, considering factors such as cost, time elapsed, provider expertise, technology changes, and medical advances.

• Allows covered services to be provided at hospitals, residential care facilities, and freestanding inpatient rehabilitation facilities; prohibits insurers from denying coverage solely based on facility type and requires adequate network access to these facilities.

• Permits insurers to exclude coverage only if an independent actuary certifies that claims for covered services caused costs to increase more than 1% annually and the superintendent of insurance approves the exclusion based on actuarial documentation.

• Requires the superintendent of insurance to adopt rules mandating training for insurance personnel handling preauthorization and utilization reviews to prevent wrongful denials of acquired brain injury coverage.