Connecticut § 38a-478f Provider profile development requirements.

Connecticut Statutes

§ 38a-478f — Provider profile development requirements.

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

Each managed care organization, in developing provider profiles or otherwise measuring health care provider performance, shall:

(1)Make allowances for the severity of illness or condition of the patient mix;

(2)make allowances for patients with multiple illnesses or conditions;

(3)make available to the commissioner documentation of how the managed care organization makes such allowances; and (4) inform enrollees and participating providers, upon request, how the managed care organization considers patient mix when profiling or evaluating providers.

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Each managed care organization, in developing provider profiles or otherwise measuring health care provider performance, shall: (1) Make allowances for the severity of illness or condition of the patient mix; (2) make allowances for patients with multiple illnesses or conditions; (3) make available to the commissioner documentation of how the managed care organization makes such allowances; and (4) inform enrollees and participating providers, upon request, how the managed care organization considers patient mix when profiling or evaluating providers.

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