Topic:
HEALTH INSURANCE; HEALTH FACILITIES; MEDICAL PERSONNEL;
Location:
INSURANCE - HEALTH - MANDATES;

OLR Research Report


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