Conn. Gen. Stat. § 38a-475

Current with legislation from the 2024 Regular and Special Sessions.

Section 38a-475 - Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations

The Insurance Department shall only precertify long-term care insurance policies that (1) alert the purchaser to the availability of consumer information and public education provided by the Department of Aging and Disability Services pursuant to section 17a-861; (2) offer the option of home and community-based services in addition to nursing home care; (3) in all home care plans, include case management services delivered by an access agency approved by the Office of Policy and Management and the Department of Social Services as meeting the requirements for such agency as defined in regulations adopted pursuant to subsection (m) of section 17b-342, which services shall include, but need not be limited to, the development of a comprehensive individualized assessment and care plan and, as needed, the coordination of appropriate services and the monitoring of the delivery of such services; (4) provide inflation protection; (5) provide for the keeping of records and an explanation of benefit reports on insurance payments which count toward Medicaid resource exclusion; and (6) provide the management information and reports necessary to document the extent of Medicaid resource protection offered and to evaluate the Connecticut Partnership for Long-Term Care. No policy shall be precertified if it requires prior hospitalization or a prior stay in a nursing home as a condition of providing benefits. The commissioner may adopt regulations, in accordance with chapter 54, to carry out the precertification provisions of this section.

(P.A. 89-352, S. 3, 6; P.A. 91-187 , S. 3 , 4 ; P.A. 93-262 , S. 1 , 87 ; P.A. 95-160 , S. 14 , 69 ; P.A. 96-139 , S. 12 , 13 ; P.A. 04-10 , S. 14 ; 04-257 , S. 62 ; P.A. 13-125 , S. 26 ; P.A. 17-15 , S. 40 ; June Sp. Sess. P.A. 17-2 , S. 314 ; P.A. 18-169 , S. 38 .)

Amended by P.A. 24-0039,S. 13 of the Connecticut Acts of the 2024 Regular Session, eff. 7/1/2024.

Amended by P.A. 19-0157, S. 91 of the Connecticut Acts of the 2019 Regular Session, eff. 10/1/2019.

Amended by P.A. 18-0169, S. 38 of the Connecticut Acts of the 2018 Regular Session, eff. 6/14/2018.

Amended by P.A. 17-0002, S. 314 of the Connecticut Acts of the 2017 Special Session, eff. 10/31/2017.

Amended by P.A. 17-0015, S. 40 of the Connecticut Acts of the 2017 Regular Session, eff. 10/1/2017.

See Sec. 17b-251 re outreach program. See Sec. 17b-252 re establishment of Connecticut Partnership for Long-Term Care pilot program. See Sec. 17b-253 re amendments to Medicaid regulations and state plan, and regulations re determining eligibility of applicants for Medicaid and coverage requirements for long-term care benefits. See Sec. 17b-254 re foundation funds and federal approval and report to General Assembly.