General Assembly		Substitute Bill No. 6867
January Session, 2015		*_____HB06867INS___031815____*

AN ACT CONCERNING HEALTH CARE PROVIDER NETWORK ADEQUACY.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 38a-472f of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2015):

Each insurer, health care center, managed care organization or other entity that delivers, issues for delivery, renews, amends or continues an individual or group health insurance policy or medical benefits plan, and each preferred provider network, as defined in section 38a-479aa, that contracts with a health care provider, as defined in section 38a-478, for the purposes of providing covered health care services to its enrollees, shall maintain a network of such providers that is consistent with the National Committee for Quality Assurance's network adequacy requirements or URAC's provider network access and availability standards. Each provider network shall be adequate to meet the comprehensive needs of the enrollees of the insurer, health care center, managed care organization or other entity and provide an appropriate choice of health care providers sufficient to provide the services covered under the policies or plans of such insurer, health care center, managed care organization or other entity.

This act shall take effect as follows and shall amend the following sections:
Section 1	October 1, 2015	38a-472f

INS

Joint Favorable Subst.