§ 38a-526a — Coverage for telehealth services.

Connecticut § 38a-526a

• Jurisdiction: Connecticut
• Title 38a: Insurance
• Ch. 700c: Health Insurance

Text

(a) As used in this section, (1) “telehealth” has the same meaning as provided in section 19a-906, and (2) “telehealth provider” means any physician licensed under chapter 370, physical therapist licensed under chapter 376, chiropractor licensed under chapter 372, naturopath licensed under chapter 373, podiatrist licensed under chapter 375, occupational therapist licensed under chapter 376a, optometrist licensed under chapter 380, registered nurse or advanced practice registered nurse licensed under chapter 378, physician assistant licensed under chapter 370, psychologist licensed under chapter 383, marital and family therapist licensed under chapter 383a, clinical social worker or master social worker licensed under chapter 383b, alcohol and drug counselor licensed under chapter 376b, professional counselor licensed under chapter 383c, dietitian-nutritionist certified under chapter 384b, speech and language pathologist licensed under chapter 399, respiratory care practitioner licensed under chapter 381a, audiologist licensed under chapter 397a, pharmacist licensed under chapter 400j or paramedic licensed pursuant to chapter 384d who is providing health care or other health services through the use of telehealth within such person's scope of practice and in accordance with the standard of care applicable to the profession. (b) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide coverage for medical advice, diagnosis, care or treatment provided through telehealth, to the extent coverage is provided for such advice, diagnosis, care or treatment when provided through in-person consultation between the insured and a health care provider licensed in the state. Such coverage shall be subject to the same terms and conditions applicable to all other benefits under such policy. (c) No such policy shall: (1) Exclude a service for coverage solely because such service is provided only through telehealth and not through in-person consultation between the insured and a health care provider, provided telehealth is appropriate for the provision of such service; or (2) be required to reimburse a treating or consulting health care provider licensed in the state for the technical fees or technical costs for the provision of telehealth services. (d) Nothing in this section shall prohibit or limit a health insurer, health care center, hospital service corporation, medical service corporation or other entity from conducting utilization review for telehealth services, provided such utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review for an in-person consultation for the same service. See Sec. 38a-499a for similar provisions re individual policies.

Legislative History

(P.A. 15-88, S. 3; P.A. 17-15, S. 66; P.A. 22-81, S. 40; P.A. 24-110, S. 6, 7.) History: P.A. 15-88 effective January 1, 2016; P.A. 17-15 made a technical change in Subsec. (a); P.A. 22-81 amended Subsecs. (b) and (c) by adding “licensed in the state” re health care provider, effective July 1, 2024; (Revisor's note: In 2023, the words “of the general statutes” following a reference to Sec. 38-469 were deleted editorially by the Revisors for consistency with customary usage); P.A. 24-110 amended Subsec. (a) by designating existing provisions as Subdiv. (1) and adding Subdiv. (2) defining “telehealth provider”, effective June 4, 2024.