Raised Bill No. 6832, introduced in the January Session of 2023, proposes amendments to Section 38a-591c of the general statutes by adding subsections (e) and (f), effective October 1, 2023. The bill mandates the development of technical standards for the electronic filing of prior authorization requests and other requests for prospective or concurrent utilization reviews by hospitals and healthcare professionals with health carriers. It also requires the establishment of standardized clinical review criteria for common services, treatments, and procedures provided in hospitals. The commissioner is tasked with developing these standards and criteria in consultation with standard-setting organizations, hospitals, healthcare professionals, health carriers, and health information technology software vendors.

Furthermore, the bill stipulates that by March 1, 2024, each health carrier must establish an electronic program for the secure electronic filing of prior authorization requests and the transmission of the carrier's responses. These electronic programs must comply with the standards set by the commissioner. The bill also specifies that health carriers must provide hospitals and healthcare professionals with access to their criteria for making determinations on prior authorization requests, including any required documentation. Health carriers are required to consult with hospitals to ensure seamless transmission and processing of these requests, including the submission and secure access to electronic health information. The act will amend Section 38a-591c(e) and (f) and has received favorable recommendations from the INS and APP committees.

Statutes affected:
Raised Bill:
INS Joint Favorable:
File No. 317:
APP Joint Favorable: