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Current as of January 01, 2025 | Updated by Findlaw Staff
(a) No individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (10), (11) and (12) of section 38a-469, delivered, issued for delivery or renewed in this state, on or after January 1, 2025, shall direct or require an enrollee to obtain approval from the insurer or health care center prior to (1) calling a 9-1-1 local prehospital emergency medical service system whenever such enrollee is confronted with a life or limb threatening emergency, or (2) transporting such enrollee when medically necessary by ambulance to a hospital. For purposes of this section, a “life or limb threatening emergency” means any event which the enrollee believes threatens such enrollee's life or limb in such a manner that a need for immediate medical care is created to prevent death or serious impairment of health.
(b) No insurer or health care center subject to the provisions of subsection (a) of this section shall deny payment to any ambulance provider responding to a 9-1-1 local prehospital emergency medical service system call on the basis that the enrollee did not obtain approval from such insurer or health care center prior to calling such emergency medical service system or prior to transporting such enrollee when medically necessary by ambulance to a hospital.
Cite this article: FindLaw.com - Connecticut General Statutes Title 38A. Insurance § 38a-498a. Prior authorization prohibited for certain 9-1-1 emergency calls - last updated January 01, 2025 | https://codes.findlaw.com/ct/title-38a-insurance/ct-gen-st-sect-38a-498a/
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