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. 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

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