2019 Connecticut General Statutes
Title 38a - Insurance
Chapter 700c - Health Insurance
Section 38a-478d - Provider directory. Notification to enrollee of termination or withdrawal of enrollee's primary care provider.
For any contract delivered, issued for delivery, renewed, amended or continued in this state, each managed care organization shall:
(1) Provide at least annually to each enrollee a provider directory that conforms to the requirements of section 38a-477h. Such directory shall include, under a separate category or heading, participating advanced practice registered nurses; and
(2) For a managed care plan that requires the selection of a primary care provider:
(A) Allow an enrollee to designate a participating, in-network physician or a participating, in-network advanced practice registered nurse as such enrollee's primary care provider; and
(B) Provide notification in accordance with subsection (g) of section 38a-472f to each such enrollee upon the termination or withdrawal of the enrollee's primary care provider.
(P.A. 97-99, S. 5; P.A. 07-18, S. 1; P.A. 11-199, S. 1; P.A. 16-205, S. 6.)
History: P.A. 07-18 amended Subdiv. (1) to require that list of providers be given in writing or through the Internet at the option of enrollee and amended Subdiv. (2) to limit notification to enrollee in a managed care plan that requires selection of a primary care physician; P.A. 11-199 substantially revised section to require managed care organizations to include in their provider listings advanced practice registered nurses under a separate category or heading and to allow enrollees to designate a participating, in-network physician or a participating, in-network advanced practice registered nurse as such enrollee's primary care provider; P.A. 16-205 deleted former Subdiv. (1) re listing of providers, redesignated existing Subdiv. (2) as Subdiv. (1) and amended same by adding provision re provider directory and making a conforming change, and redesignated existing Subdiv. (3) re managed care plan as Subdiv. (2) and amended same by replacing “, as soon as possible” with reference to Sec. 38a-472f(g) in Subpara. (B), effective January 1, 2017.
