§ 38a-518v

(a) As used in this section, 'hospice care program' has the same meaning as provided in section 19a-122e.(b) Each group 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 hospice services provided to an insured in the home through a hospice care program, to the extent coverage is provided for inpatient hospice services in a hospital. Such coverage shall be subject to the same terms and conditions applicable to all other benefits under such policy.(c) No such policy shall exclude a hospice service for coverage solely because such service is provided in the home and not at a hospital, provided hospice care in the home is appropriate for the insured.(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 an in-home hospice services, provided such utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review

from conducting utilization review for an in-home hospice services, provided such utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review for the same hospice services provided in a hospital.(P.A. 23-174, S. 4.)History: P.A. 23-174 effective January 1, 2024.

(a) As used in this section, 'hospice care program' has the same meaning as provided in section 19a-122e.(b) Each group 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 hospice services provided to an insured in the home through a hospice care program, to the extent coverage is provided for inpatient hospice services in a hospital. Such coverage shall be subject to the same terms and conditions applicable to all other benefits under such policy.(c) No such policy shall exclude a hospice service for coverage solely because such service is provided in the home and not at a hospital, provided hospice care in the home is appropriate for the insured.(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 an in-home hospice services, provided such utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review

from conducting utilization review for an in-home hospice services, provided such utilization review is conducted in the same manner and uses the same clinical review criteria as a utilization review for the same hospice services provided in a hospital.(P.A. 23-174, S. 4.)History: P.A. 23-174 effective January 1, 2024.