Bill Text: CT HB06381 | 2013 | General Assembly | Introduced
Bill Title: An Act Concerning Health Insurance Claim Forms And Uniform Treatment Authorization Forms For Mental Health Services.
Spectrum: Committee Bill
Status: (Introduced - Dead) 2013-02-15 - Public Hearing 02/19 [HB06381 Detail]
Download: Connecticut-2013-HB06381-Introduced.html
General Assembly |
Raised Bill No. 6381 | ||
January Session, 2013 |
LCO No. 2627 | ||
*02627_______INS* | |||
Referred to Committee on INSURANCE AND REAL ESTATE |
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Introduced by: |
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(INS) |
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AN ACT CONCERNING HEALTH INSURANCE CLAIM FORMS AND UNIFORM TREATMENT AUTHORIZATION FORMS FOR MENTAL HEALTH SERVICES.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Subsections (a) and (b) of section 38a-477 of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2013):
(a) Except where there is an agreement to the contrary between a third-party payer and the health care provider, as defined in section 19a-17b, all health care providers shall submit all third-party claims for payment on the current standard Health Care Financing Administration Fifteen Hundred (HCFA1500) health insurance claim form or its successor, or in the case of a hospital or other health care institution, a Health Care Financing Administration UB-92 health insurance claim form or its successor, or in accordance with other forms [which] that may be prescribed by the Insurance Commissioner. With respect to the Health Care Financing Administration Fifteen Hundred health insurance claim form or its successor or other form prescribed by the commissioner for third-party claims for payment, a health care provider shall be allowed to use a National Provider Identifier assigned to such provider by the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System in lieu of such provider's federal tax identification number.
(b) For any claim submitted to an insurer on the current standard Health Care Financing Administration Fifteen Hundred health insurance claim form or its successor, if the following information is completed and received by the insurer, the claim may not be deemed to be deficient in the information needed for filing a claim for processing pursuant to subparagraph (B) of subdivision (15) of section 38a-816.
T1 |
Item Number |
Item Description |
T2 |
1a |
Insured's identification number |
T3 |
2 |
Patient's name |
T4 |
3 |
Patient's birth date and sex |
T5 |
4 |
Insured's name |
T6 |
10a |
Patient's condition - employment |
T7 |
10b |
Patient's condition - auto accident |
T8 |
10c |
Patient's condition - other accident |
T9 |
11 |
Insured's policy group number |
T10 |
(if provided on identification card) | |
T11 |
11d |
Is there another health benefit plan? |
T12 |
17a |
Identification number of referring physician or |
T13 |
advanced practice registered nurse | |
T14 |
(if required by insurer) | |
T15 |
21 |
Diagnosis |
T16 |
24A |
Dates of service |
T17 |
24B |
Place of service |
T18 |
24D |
Procedures, services or supplies |
T19 |
24E |
Diagnosis code |
T20 |
24F |
Charges |
T21 |
25 |
Federal tax identification number |
T22 |
or National Provider Identifier | |
T23 |
28 |
Total charge |
T24 |
31 |
Signature of physician, advanced practice |
T25 |
registered nurse or supplier with date | |
T26 |
33 |
Physician's, advanced practice registered nurse's |
T27 |
or supplier's billing name, | |
T28 |
address, zip code & telephone number |
Sec. 2. (Effective from passage) Not later than January 1, 2014, the Commissioner of Public Health, in consultation with the Insurance Commissioner, the Commissioner of Mental Health and Addiction Services, the Attorney General and the Healthcare Advocate, shall develop a uniform treatment authorization form for mental health services. Such form shall (1) be used by health care providers and hospitals in this state to obtain patient authorization and information for the provision of mental health services, (2) meet, at a minimum, privacy standards set forth in state and federal privacy laws, including, but not limited to, the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended from time to time, and any regulations adopted thereunder, and (3) comply with state and federal mental health parity laws. Not later than February 12, 2014, the Commissioner of Public Health shall submit any proposed legislation the Commissioner of Public Health deems necessary to implement the use of such form to the joint standing committee of the General Assembly having cognizance of matters relating to public health.
This act shall take effect as follows and shall amend the following sections: | ||
Section 1 |
October 1, 2013 |
38a-477(a) and (b) |
Sec. 2 |
from passage |
New section |
Statement of Purpose:
To allow health care providers to use a National Provider Identifier in lieu of a federal tax identification number on an HCFA1500 payment claim form, and to require the development of a uniform treatment authorization form for mental health services.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]