Connecticut § 38a-477nn Prohibition on denial of reimbursement or prevention from participating in provider network based solely on health care provider's decision not to maintain specialty certification.

Connecticut Statutes

§ 38a-477nn — Prohibition on denial of reimbursement or prevention from participating in provider network based solely on health care provider's decision not to maintain specialty certification.

Connecticut·Title 38a Insurance·Ch. 700c Health Insurance

(a)For purposes of this section:

(1)“Health care provider” has the same meaning as provided in section 38a-477aa ;

(2)“Maintenance of certification” means any process requiring periodic recertification examinations or other professional development activities to maintain specialty certification; and (3) “Specialty certification” means any certification by a medical board that specializes in one area of medicine and has requirements in addition to licensing requirements in this state.

(b)No insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues an individual or group health insurance policy providing coverage of the type specified in subdivisions (1)

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(a) For purposes of this section: (1) “Health care provider” has the same meaning as provided in section 38a-477aa ; (2) “Maintenance of certification” means any process requiring periodic recertification examinations or other professional development activities to maintain specialty certification; and (3) “Specialty certification” means any certification by a medical board that specializes in one area of medicine and has requirements in addition to licensing requirements in this state. (b) No insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues an individual or group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 in this state on or after January 1, 2025, shall deny reimbursement to a health care provider or prevent any health care provider from participating in any provider network based solely on such health care provider's decision not to maintain a specialty certification, including, but not limited to, through participation in any maintenance of certification program, provided such health care provider does not hold such health care provider out to be a specialist under such specialty certification.

Connecticut § 38a-477nn (Prohibition on denial of reimbursement or prevention from participating in provider network based solely on health care provider's decision not to maintain specialty certification.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.