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AI Summary
This bill establishes the parity advancement account, prohibits step therapy for prescription drugs, and sets requirements for stop loss insurance policies, among other protections.
Business Impact
If you are a health carrier in Connecticut, you must ensure that AI is not used for adverse determinations or face penalties.
What do these statuses mean? ▼
Introduced
— Filed in the legislature; not yet heard in committee
In Committee
— Assigned to and being reviewed by a legislative committee
Passed
— Approved by one or both chambers; awaiting further action
Signed / Enacted
— Signed into law by the governor; may or may not be in effect yet
Dead / Vetoed
— Vetoed, failed to pass, or session expired without action
Unknown
— Status data not yet available or awaiting classification
Affected Industries
Topics How we classify →
What This Means
Connecticut's SB10 addresses critical aspects of health insurance and patient protection, including mental health benefits, step therapy prohibitions, and stop loss insurance requirements. It mandates health carriers to prove medical necessity for certain services and prohibits the use of artificial intelligence in making adverse determinations. This legislation aims to enhance patient protections and ensure compliance with mental health benefit laws.
Key Provisions
- Establishes reporting requirements for mental health and substance use disorder benefits.
- Health carriers must prove that services are not medically necessary in adverse determinations.
- Prohibits the use of step therapy for prescription drugs.
- Requires specific provisions in contracts with healthcare providers regarding reimbursements.
- Sets requirements for stop loss insurance policies in self-funded health plans.
- Prohibits the use of AI for adverse determinations based on medical necessity.
- Establishes the parity advancement account.
- Includes health insurance rate filing requirements and the Insurance Commissioner's role in adopting regulations concerning affordability.
- Prohibits arbitrary time limits on reimbursement for general anesthesia services and unilateral arbitrary limitations on reimbursement for medically necessary ancillary services.
Latest Legislative Action
Signed by the Governor
Bill Sponsors (showing 5 of 41)
| Name | Role | District |
|---|---|---|
| Anne Hughes D | Sponsor | HD-135 |
| Catherine Osten D | Sponsor | SD-019 |
| Christine Cohen D | Sponsor | SD-012 |
| Cici Maher D | Sponsor | SD-026 |
| Cristin McCarthy Vahey D | Sponsor | HD-133 |
Roll Call Votes (showing 3 of 7)
H ·
House Roll Call Vote 272 AS AMENDED ·
Jun 2, 2025
122 Yea
26 Nay
3 Other
Passed ✓
H ·
House Roll Call Vote 271 HOUSE AMD A ·
Jun 2, 2025
47 Yea
99 Nay
5 Other
S ·
Senate Roll Call Vote 211 ·
May 21, 2025
31 Yea
5 Nay
Passed ✓
Amendments (20)
Senate LCO Amendment #8138 (D)
Pending
2025-05-09
Senate LCO Amendment #8638 (D)
Pending
2025-05-19
Senate LCO Amendment #8935 (R)
Pending
2025-05-20
Senate LCO Amendment #8932 (R)
Pending
2025-05-20
Senate LCO Amendment #8934 (R)
Pending
2025-05-20
Senate LCO Amendment #8930 (R)
Pending
2025-05-20
Senate LCO Amendment #8927 (R)
Pending
2025-05-20
Senate LCO Amendment #8944 (R)
Pending
2025-05-21
Senate LCO Amendment #8941 (R)
Pending
2025-05-21
Senate LCO Amendment #8940 (R)
Pending
2025-05-21
Senate LCO Amendment #8943 (R)
Pending
2025-05-21
Senate LCO Amendment #8939 (R)
Pending
2025-05-21
Senate LCO Amendment #8938 (R)
Pending
2025-05-21
Senate LCO Amendment #8937 (R)
Pending
2025-05-21
Senate Schedule A LCO# 8995 (D)
Pending
2025-05-21
Senate LCO Amendment #8980 (R)
Pending
2025-05-21
Senate LCO Amendment #8953 (R)
Pending
2025-05-21
Senate LCO Amendment #8951 (R)
Pending
2025-05-21
House LCO Amendment #10230 (R)
Pending
2025-06-01
House Schedule A LCO# 10230 (R)
Pending
2025-06-01
Compliance Checklist
Ensure AI is not used for adverse determinations based on medical necessity.
Who: Health carriers
Penalty: Potential penalties for non-compliance.
Who: Health carriers
Penalty: Potential penalties for non-compliance.
Implement new reporting requirements for mental health benefits.
Who: Health carriers
Penalty: Potential penalties for non-compliance.
Who: Health carriers
Penalty: Potential penalties for non-compliance.
Full Legal Analysis
SB10 introduces several key provisions aimed at improving health insurance compliance and patient protections. Notably, it requires health carriers to demonstrate that certain healthcare services are not medically necessary when making adverse determinations. This shifts the burden of proof onto the carriers, enhancing accountability in decision-making processes. Additionally, the bill explicitly prohibits the use of artificial intelligence in making adverse determinations based on medical necessity, reflecting a growing concern over automated decision-making in healthcare. The bill establishes the parity advancement account to support these initiatives. It also prohibits the use of step therapy for prescription drugs, ensuring patients receive timely access to necessary medications. Health carriers must adhere to new reporting requirements and ensure that contracts with healthcare providers include specific provisions regarding reimbursement for covered health benefits. The bill sets requirements for stop loss insurance policies in self-funded health plans and includes health insurance rate filing requirements, with the Insurance Commissioner adopting regulations concerning affordability. Furthermore, it prohibits imposing arbitrary time limits on reimbursement for general anesthesia services and unilateral arbitrary limitations on reimbursement for medically necessary ancillary services. Failure to comply with these regulations could result in significant penalties, emphasizing the importance of adherence to the new standards. Overall, SB10 represents a comprehensive effort to bolster patient protections and ensure equitable access to mental health and substance use disorder services.
Official Source
Official Bill Text
View SB10 on official legislature website →
Related Topics
Affected Industries
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