2022 Connecticut General Statutes
Title 38a - Insurance
Chapter 700c - Health Insurance
Section 38a-499a. - *(See end of section for amended version and effective date.) Coverage for telehealth services.
(a) As used in this section, “telehealth” has the same meaning as provided in section 19a-906.
(b) Each individual 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. 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 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.
(P.A. 15-88, S. 2; P.A. 17-15, S. 55.)
*Note: On and after July 1, 2024, this section, as amended by section 39 of public act 22-81, is to read as follows:
“Sec. 38a-499a. Coverage for telehealth services. (a) As used in this section, “telehealth” has the same meaning as provided in section 19a-906.
(b) Each individual 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 licensed in the state, provided telehealth is appropriate for the provision of such service; or (2) be required to reimburse a treating or consulting health care provider 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.”
(P.A. 15-88, S. 2; P.A. 17-15, S. 55; P.A. 22-81, S. 39.)
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).
See Sec. 38a-526a for similar provisions re group policies.
