Connecticut SB 342: AN ACT CONCERNING LIABILITY FOR INJURIES OCCURRING IN A SKATEBOARD PARK OR DOG PARK MAINTAINED BY A MUNICIPALITY.

Bill Text

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General Assembly Raised Bill No. 342
February Session, 2026 LCO No. 2248

Referred to Committee on INSURANCE AND REAL ESTATE

Introduced by:
(INS)

AN ACT CONCERNING HEALTH COVERAGE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. (NEW) (Effective July 1, 2026) (a) Each insurer, health care 1
center, hospital service corporation, medical service corporation, 2
preferred provider network or other entity that enters into, renews or 3
amends a contract with a health care provider on or after July 1, 2026, to 4
provide covered benefits to insureds or enrollees in this state shall 5
include in such contract: 6
(1) A provision requiring such insurer, health care center, hospital 7
service corporation, medical service corporation, preferred provider 8
network or other entity to: 9
(A) Reimburse the contracting health care provider for a covered 10
outpatient benefit that uses a current procedural terminology 11
evaluation and management (CPT E/M) code, current procedural 12
terminology assessment and management (CPT A/M) code, telehealth 13
codes or drug infusion code in an amount that does not vary based on 14
the facility where the contracting health care provider provides such 15

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benefit; and 16
(B) Use equal reimbursement rates for all contracting health care 17
providers in the same geographic region, as determined by the 18
Insurance Commissioner, and regardless of the employer or affiliation 19
of any contracting health care provider, for each covered outpatient 20
benefit described in subparagraph (A) of this subdivision if the 21
reimbursement for such covered outpatient benefit is made on a fee-for-22
benefit basis or on the basis of bundled benefits per diagnosis, condition, 23
procedure or another standardized bundle of health care benefits; and 24
(2) A conspicuous statement that such contract complies with the 25
provisions of subdivision (1) of this subsection. 26
(b) The Insurance Commissioner shall adopt regulations, in 27
accordance with the provisions of chapter 54 of the general statutes, to 28
implement the provisions of this section. 29
Sec. 2. Subdivision (2) of subsection (a) of section 38a-477i of the 30
general statutes is repealed and the following is substituted in lieu 31
thereof (Effective October 1, 2026): 32
(2) "Anti-steering clause" means any provision, including, but not 33
limited to, utilization management provisions, in a health care contract 34
that restricts the ability of the health carrier or health plan administrator 35
from encouraging an enrollee to obtain a health care service from a 36
competitor of a hospital or health system, including offering incentives 37
to encourage enrollees to utilize specific health care providers such as 38
centers of excellence or any other pay-for-performance program; 39
Sec. 3. (Effective from passage) The Insurance Commissioner shall 40
conduct a study concerning various revisions to the insurance statutes, 41
including, but not limited to, statutes concerning (1) excess insurance, 42
(2) the Health Care Cabinet, and (3) outpatient health care services, 43
including, injections and infusions, provided at a hospital-based facility 44
located off-site from a hospital campus. Not later than January 1, 2027, 45
the commissioner shall submit a report, in accordance with the 46

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provisions of section 11-4a of the general statutes, to the joint standing 47
committee of the General Assembly having cognizance of matters 48
relating to insurance on the results and recommendations of such study. 49
Sec. 4. (NEW) (Effective October 1, 2026) (a) For purposes of this 50
section, "clinical peer" has the same meaning as provided in section 38a-51
591a of the general statutes, "health carrier" has the same meaning as 52
provided in section 38a-1080 of the general statutes and "downcode" 53
means any adjustment of a health benefit claim by any insurer, health 54
care center, hospital service corporation, medical service corporation, 55
preferred provider network or other entity to a less complex or lower 56
cost billing code in order to provide a lower reimbursement to a health 57
care provider for such health benefit claim than is required for the actual 58
service performed pursuant to such contract between such health care 59
provider and such entity. 60
(b) No health carrier shall use a software tool, including, but not 61
limited to, artificial intelligence or an algorithm, to automatically 62
downcode or deny a health insurance claim submitted by a health care 63
provider without review by a clinical peer. 64
Sec. 5. Subparagraph (C) of subdivision (1) of subsection (g) of section 65
38a-472f of the general statutes is repealed and the following is 66
substituted in lieu thereof (Effective October 1, 2026): 67
(C) For each contract entered into, renewed, amended or continued 68
on or after July 1, 2023, be