Sec. 38a-478a. Commissioner's report to the Governor and the General Assembly.
Sec. 38a-478a. Commissioner's report to the Governor and the General Assembly. On March 1, 1999, and annually thereafter, the Insurance Commissioner shall
submit a report, to the Governor and to the joint standing committees of the General
Assembly having cognizance of matters relating to public health and relating to insurance, concerning the commissioner's responsibilities under the provisions of sections
38a-226 to 38a-226d, inclusive, 38a-478 to 38a-478u, inclusive, 38a-479aa and 38a-993. The report shall include: (1) A summary of the quality assurance plans submitted
by managed care organizations pursuant to section 38a-478c along with suggested
changes to improve such plans; (2) suggested modifications to the consumer report card
developed under the provisions of section 38a-478l; (3) a summary of the commissioner's procedures and activities in conducting market conduct examinations of utilization
review companies and preferred provider networks, including, but not limited to: (A)
The number of desk and field audits completed during the previous calendar year; (B)
a summary of findings of the desk and field audits, including any recommendations
made for improvements or modifications; (C) a description of complaints concerning
managed care companies, and any preferred provider network that provides services to
enrollees on behalf of the managed care organization, including a summary and analysis
of any trends or similarities found in the managed care complaints filed by enrollees;
(4) a summary of the complaints received by the Insurance Department's Consumer
Affairs Division and the commissioner under section 38a-478n, including a summary
and analysis of any trends or similarities found in the complaints received; (5) a summary
of any violations the commissioner has found against any managed care organization
or any preferred provider network that provides services to enrollees on behalf of the
managed care organization; and (6) a summary of the issues discussed related to health
care or managed care organizations at the Insurance Department's quarterly forums
throughout the state.
(P.A. 97-99, S. 2; June 18 Sp. Sess. P.A. 97-8, S. 57, 88; P.A. 99-284, S. 51, 60; P.A. 00-196, S. 22; June Sp. Sess.
P.A. 01-4, S. 23; P.A. 03-169, S. 11.)
History: June 18 Sp. Sess. P.A. 97-8 changed reporting date from January 15, 1999, to March 1, 1999, and in Subdiv.
(3)(C) changed "complaints" to "managed care complaints", effective July 1, 1997; P.A. 99-284 deleted obsolete reference
to Sec. 38a-514a, effective January 1, 2000; P.A. 00-196 made a technical change; June Sp. Sess. P.A. 01-4 replaced
reference to Sec. 19a-647 with reference to Sec. 38a-479aa; P.A. 03-169 added provisions re preferred provider networks
in Subdivs. (3) and (5).