Dear Friends,
I’m excited to share with you the introduction of House Bill 6147, titled "An Act Concerning Coverage for Medically Necessary Treatment in This State," which I’ve introduced this legislative session. This bill is deeply personal to me and was inspired by the story of Daniel Pearson, a young man from the Danbury area, who is currently facing a life-or-death battle with insurance denials.
I met Daniel in 2018 while we were both running for office, and since then, I've been impressed by his dedication and resilience. Now, he is fighting to get the life-saving heart surgery his doctors have prescribed. Unfortunately, his insurance company, Aetna, has denied the treatment, even after a peer-to-peer review by his electrophysiologist. This situation, as heart-wrenching as it is, is not unique—many individuals face the same restrictive guidelines when seeking necessary care.
To help prevent these types of denials from happening in the future, House Bill 6147 includes two key reforms:
Requires insurance companies to align their coverage guidelines with up-to-date, evidence-based medical standards. It mandates that treatments recommended by licensed specialists, especially life-saving treatments, be covered unless there is clear medical evidence to deny them. Additionally, it calls for transparency from insurers, ensuring patients understand the criteria used to make coverage decisions.
Streamlines the appeals process, requiring non-urgent appeals to be decided within 10 business days and urgent appeals to be resolved within 48 hours. It also establishes an independent medical review board to ensure appeals are decided based on current medical evidence, with decisions binding in urgent cases.
I am deeply frustrated by the barriers our healthcare system creates for people like Daniel. No one should have to beg for life-saving care, and House Bill 6147 is my effort to change that. This bill aims to hold insurance companies accountable and ensure that patients receive the care they need without delay or confusion.
You can follow Daniel’s fight for the care he urgently needs on his
