Bill > HB06895

This bill revises the health benefit review process in Connecticut and requires health insurance coverage for biomarker testing. The bill modifies existing law to establish a new process for reviewing mandated health benefits, with key changes including requiring the Insurance Commissioner to engage independent experts to evaluate new health mandates, and mandating that any new health benefit passed by the General Assembly after January 1, 2026, will automatically terminate after four years unless specifically approved by a majority vote of both legislative houses. The bill introduces new requirements for comprehensive review reports that must assess the social and financial impacts of health benefits, including factors like utilization, availability, scientific effectiveness, and potential cost implications. Additionally, the bill mandates that individual and group health insurance policies must provide coverage for biomarker testing (medical tests that analyze biological indicators like gene mutations) when such testing demonstrates clinical utility and is supported by recognized medical guidelines or FDA approvals. The legislation also requires insurers to establish clear processes for requesting exceptions or disputing coverage determinations and sets specific timelines for prior authorization requests, with urgent requests to be processed within 72 hours and non-urgent requests within seven days. The bill is set to take effect on January 1, 2026, and aims to improve healthcare coverage and review processes in Connecticut.

Budget and Finance, Business and Industry

Insurance and Real Estate Committee (J)

https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=HB06895&which_year=2025