Sec. 38a-530d. Mandatory coverage for mastectomy care. Termination of provider contract prohibited.
Sec. 38a-530d. Mandatory coverage for mastectomy care. Termination of provider contract prohibited. (a) Each group health insurance policy providing coverage
of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469
delivered, issued for delivery, amended, renewed or continued in this state on or after
July 1, 1997, shall provide coverage for at least forty-eight hours of inpatient care following a mastectomy or lymph node dissection, and shall provide coverage for a longer
period of inpatient care if such care is recommended by the patient's treating physician
after conferring with the patient. No such insurance policy may require mastectomy
surgery or lymph node dissection to be performed on an outpatient basis. Outpatient
surgery or shorter inpatient care is allowable under this section if the patient's treating
physician recommends such outpatient surgery or shorter inpatient care after conferring
with the patient.
(b) No group health insurance carrier may terminate the services of, require additional documentation from, require additional utilization review, reduce payments or
otherwise penalize or provide financial disincentives to any attending health care provider on the basis that the provider orders care consistent with the provisions of this
section.
(P.A. 97-198, S. 2, 5.)
History: P.A. 97-198 effective July 1, 1997.
See Sec. 38a-503d for similar provisions re individual policies.