AN ACT CONCERNING ADVERSE DETERMINATION AND UTILIZATION REVIEWS.

SB 1044 requires health insurance carriers to prove that denied medical services are not medically necessary, shifting the burden of proof from patients to insurers. This directly affects patients and healthcare providers who face insurance denials for treatments or procedures. The key provision mandates that insurers must provide documented evidence of medical necessity when reviewing or denying coverage, rather than expecting patients to disprove the need. The bill aims to streamline appeals for necessary care by making insurers justify denials.