February 14, 08 |
2008-R-0138 Revised | |
MANDATED PROVIDERS AND FACILITIES FOR HEALTH INSURANCE | ||
By: Janet L. Kaminski Leduc, Associate Legislative Attorney | ||
You asked for a list of health care providers and facilities that Connecticut law requires health insurance policies to cover.
In Connecticut, health insurance mandates are contained in Chapter 700c of the general statutes.
Table 1 provides a list of the mandated providers (e.g., social worker, nurse practitioner). Table 2 provides a list of mandated facilities (e.g., residential treatment facility).
See OLR Research Report 2007-R-0703 for a list of the mandated benefits (e.g., mammograms, mental health services).
Due to federal preemption, state insurance mandates generally do not apply to self-insured plans. (For more information, see OLR Research Report 2005-R-0753, Self-Insurance Benefit Plans and Insurance Mandates.)
Table 1: Connecticut Health Care Insurance Mandated Providers
CGS § |
Provider |
|
38a-488a 38a-514 |
● Licensed physician ● Licensed psychiatrist ● Licensed psychologist ● Licensed clinical social worker ● Independent social worker certified before October 1, 1990 ● Licensed marital and family therapist ● Marital and family therapist certified before October 1, 1992 ● Licensed alcohol and drug counselor ● Certified alcohol and drug counselor ● Licensed professional counselor |
38a-491 38a-517 |
● Licensed dentist |
38a-492i 38a-518i |
● Pain management specialist (i.e., a physician credentialed by the American Academy of Pain Management or who is a board-certified anesthesiologist, neurologist, oncologist, or radiation oncologist with additional training in pain management) |
38a-496 38a-524 |
● Licensed occupational therapist |
38a-499 38a-526 |
● Licensed physician assistant ● Certified nurse practitioner ● Certified psychiatric-mental health clinical nurse specialist ● Certified nurse mid-wife |
38a-503b 38a-530b |
● Obstetrician-gynecologist ● Nurse mid-wife ● Advanced practice nurse |
38a-507 38a-534 |
● Licensed chiropractor |
38a-523 (Optional benefit for group health insurance that insurer must offer) |
Comprehensive rehabilitation services provided by: ● Physician ● Physical therapist ● Occupational therapist ● Nurse ● Psychologist ● Audiologist ● Speech therapist ● Social workers ● Respiratory therapist |
38a-553 |
● Physician ● Registered nurse ● Social worker ● Licensed physical therapist |
Table 2: Connecticut Health Care Insurance Mandated Facilities
CGS § |
Facility |
|
38a-488a 38a-514 |
● Licensed hospital or clinic ● Child guidance clinic ● Residential treatment facility ● Nonprofit community mental health center ● Nonprofit licensed adult psychiatric clinic |
38a-498b 38a-525b |
● State mobile field hospital (formerly known as critical access hospitals) |
38a-502 38a-529 |
● State Veterans' Home |
38a-523 (Optional benefit for group health insurance that insurer must offer) |
● Comprehensive rehabilitation facility |
38a-553 |
● Hospital ● Skilled nursing facility ● Licensed alcohol treatment facility |
JKL:ts