The General Assembly Raised Bill No. 7040 mandates the Insurance Commissioner to conduct a comprehensive study focusing on three key areas: the comparison of health carrier coverage guidelines in the state with the latest evidence-based guidelines from other states, the transparency measures related to utilization review by health carriers, and the mandated coverage for life-saving medical treatments or services, unless there is medical evidence to justify a denial. The bill defines "health carrier" and "utilization review" by referencing existing statutes.
The findings from this study are required to be reported to the relevant joint standing committee of the General Assembly by February 1, 2026. The bill introduces new legal language to establish this requirement, while it does not delete any existing legal language. The act is set to take effect upon passage, emphasizing the importance of evaluating health insurance practices to ensure adequate coverage for critical medical services.