Sec. 38a-526. Mandatory coverage for services of physician assistants and certain nurses.
Sec. 38a-526. Mandatory coverage for services of physician assistants and certain nurses. (a) For the purposes of this section:
(1) "Certified nurse practitioner" means any registered nurse licensed under chapter
378 who has completed a formal educational nurse practitioner program and is certified
by the American Nurses' Association, the National Board of Pediatric Nurse Practitioners and Associates or the Nurses' Association of the American College of Obstetricians and Gynecologists;
(2) "Certified psychiatric-mental health clinical nurse specialist" means any registered nurse licensed under chapter 378 who has completed a formal educational program
as a psychiatric-mental health clinical nurse specialist and is certified by the American
Nurses' Association;
(3) "Certified nurse-midwife" means any individual certified as nurse-midwife pursuant to sections 20-86a to 20-86e, inclusive;
(4) "Physician assistant" means an individual licensed pursuant to section 20-12b.
(b) Each group health insurance policy providing coverage of the type specified in
subdivisions (1), (2), (4), (6), (11) and (12) of section 38a-469 delivered, issued for
delivery or renewed in this state on or after October 1, 1984, shall provide coverage for
the services of physician assistants, certified nurse practitioners, certified psychiatric-mental health clinical nurse specialists and certified nurse-midwives if such services
are within the individual's area of professional competence as established by education
and licensure or certification and are currently reimbursed when rendered by any other
licensed health care provider. Subject to the provisions of chapter 378 and sections 20-86a to 20-86e, inclusive, no insurer, hospital or medical service corporation or health
care center may require signature, referral or employment by any other health care
provider as a condition of reimbursement, provided no insurer, hospital or medical service corporation or health care center may be required to pay for duplicative services
actually rendered by both a physician assistant or a certified registered nurse and any
other health care provider. The payment of such benefits shall be subject to any policy
provisions which apply to other licensed health practitioners providing the same services. Nothing in this section may be construed as permitting (1) any registered nurse
to perform or provide services beyond the scope of practice permitted in chapter 378
and sections 20-86a to 20-86e, inclusive, or (2) any physician assistant to perform or
provide services beyond the scope of practice permitted in chapter 370.
(P.A. 90-243, S. 110; P.A. 95-74, S. 8, 9.)
History: P.A. 95-74 added physician assistants to those whose services must be included in coverage and defined
"physician assistant", effective July 1, 1995 (Revisor's note: In Subsec. (b) "physicians' assistants" was changed editorially
by the Revisors to "physician assistants" for consistency).
See Sec. 38a-499 for similar provisions re individual policies.