Sec. 38a-523. (Formerly Sec. 38-174p). Group hospital or medical insurance coverage for comprehensive rehabilitation services.
Sec. 38a-523. (Formerly Sec. 38-174p). Group hospital or medical insurance
coverage for comprehensive rehabilitation services. (a) For the purposes of this
section:
(1) "Comprehensive rehabilitation services" shall consist of the following when
provided in a comprehensive rehabilitation facility pursuant to a plan of care approved
in writing by a physician licensed in accordance with the provisions of chapter 370 and
reviewed by such physician at least every thirty days to determine that continuation of
such services are medically necessary for the rehabilitation of the patient: (A) Physician
services, physical and occupational therapy, nursing care, psychological and audiological services and speech therapy provided by health care professionals who are licensed
by the appropriate state licensing authority to perform such services; (B) social services
by a social worker holding a master's degree from an accredited school of social work;
(C) respiratory therapy by a certified respiratory therapist; (D) prescription drugs and
medicines which cannot be self-administered; (E) prosthetic and orthotic devices, including the testing, fitting or instruction in the use of such devices; (F) other supplies
or services prescribed by a physician for the rehabilitation of a patient and ordinarily
furnished by a comprehensive rehabilitation facility.
(2) "Comprehensive rehabilitation facility" means a facility which is: (A) Primarily
engaged in providing diagnostic, therapeutic and restorative services through such licensed health care professionals to injured, ill or disabled individuals solely on an outpatient basis and (B) accredited for the provision of such services by the Commission on
Accreditation for Rehabilitation Facilities or the Professional Services Board of the
American Speech-Language Hearing Association.
(b) Any insurance company, hospital or medical service corporation or health care
center authorized to do the business of health insurance in this state shall offer to any
individual, partnership, corporation or unincorporated association providing group
health insurance coverage of the type specified in subdivisions (1), (2), (4), (6), (11)
and (12) of section 38a-469 for its employees or members, a group hospital or medical
service plan or contract providing coverage for expenses incurred for comprehensive
rehabilitation services under such terms and conditions as are agreed to by the policyholder and the insurer.
(P.A. 82-20, S. 1, 2; P.A. 90-243, S. 107.)
History: P.A. 90-243 added a reference to "health care center" and substituted the reference to "health insurance policy"
for "hospital or medical insurance coverage"; Sec. 38-174p transferred to Sec. 38a-523 in 1991.