State Law

General Statutes of Connecticut-Title 38a-Chapter 700c. Health Insurance

07/29/2023 Connecticut Section 38a-478f

Provider profile development requirements


Each managed care organization, in developing provider profiles or otherwise measuring health care provider performance, shall: (1) Make allowances for the severity of illness or condition of the patient mix; (2) make allowances for patients with multiple illnesses or conditions; (3) make available to the commissioner documentation of how the managed care organization makes such allowances; and (4) inform enrollees and participating providers, upon request, how the managed care organization considers patient mix when profiling or evaluating providers.