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. This report has been updated by OLR Report 2015-R-0273.
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