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2010 Connecticut Mandated Health Insurance Benefits Reviews Connecticut Mandated Health Insurance Benefits Reviews 2010 Volume III The Center for Public Health and Health Policy, a research and programmatic center founded in 2004, integrates public health knowledge across the University of Connecticut campuses and leads initiatives in public health research, health policy research, health data analysis, health information technology, community engagement, service learning, and selected referral services. http://publichealth.University of Connecticut.edu/aboutus.php © January 2011, University of Connecticut Connecticut Mandated Health Insurance Benefit Reviews Volume III. Introduction Volume III contains ten of the forty-five comprehensive reviews of existing health insurance required benefits (mandates) completed by the University of Connecticut Center for Public Health and Health Policy pursuant to Public Act 09-179. (P.A. 09-179 is attached to this report as Appendix I.) The mandates in Volume III are found in Title 38a of the Connecticut General Statutes Annotated and apply to certain individual and group health insurance policies delivered, issued for delivery, renewed or continued in this state after the effective date of the respective statute. The types of policies to which health insurance mandates may apply as described in CGSA § 38a-469 include: • Basic hospital expense coverage (Subsection 1) • Basic medical-surgical expense coverage (Subsection 2) • Hospital confinement indemnity coverage (Subsection 3) • Major medical expense coverage (Subsection 4) • Disability income protection coverage (Subsection 5) • Accident only coverage (Subsection 6) • Long term care coverage (Subsection 7) • Specified accident coverage (Subsection 8) • Medicare supplement coverage (Subsection 9) • Limited benefit health coverage(Subsection 10) • Hospital or medical service plan contract (Subsection 11) • Hospital and medical coverage provided to subscribers of a health care center (Subsection 12) • Specified disease coverage (Subsection 13). Volume III is intended to be read in conjunction with the General Overview and actuarial report for these mandates prepared by Ingenix Consulting. The Ingenix Consulting report for this set of mandates is attached to this Volume as Appendix II. The following table lists the mandates covered in this volume and the chapter in which each is reviewed; their statutory references (from CGSA Title 38a); and the applicable policy types. The order in which they are listed coincides with the order in which they are reviewed in the Ingenix Consulting report. 1 Index of Mandates: Volume III Individual Group Policy Types policy plan Applicable Chapter Description statute statute (Subsection) 1 Psychotropic Drug Availability § 476b § 476b 1,2,4,11,12 2 Mental or Nervous Conditions § 488a § 514 1,2,4,11,12 3 Accidental Ingestion or Consumption of Controlled § 492 § 518 1,2,4,6,11,12 Drugs 4 Denial of Coverage Prohibited for Health Care Services § 498c § 525c 1,2,4,11,12 to Persons with an Elevated Blood Alcohol Content 5 Treatment of Medical Complications of Alcoholism N/A § 533 1,2,4,11,12 6 Occupational Therapy § 496 § 524 1,2,4,6,11,12 7 Services of Physician Assistants and Certain Nurses § 499 § 526 1,2,4,6,11,12 8 Services Provided by the Veterans’ Home § 502 § 509 Not indicated 9 Direct Access to OB/GYNs § 503b § 530b 1,2,4,6,11,12 10 Chiropractic Services § 507 § 534 1,2,4,6,11,12 Each chapter reviews a single mandate and includes five sections: Overview, Background, Methods, Social Impact, and Financial Impact. The Overview includes the statutory references and the language of the mandate, the effective date, the premium impact, and the extent to which the mandated benefit is included in self-funded plans. The Background describes the disease, condition, treatment or provider to which the mandate applies, provides information on the current research and other pertinent information for each mandate. The Methods section documents the research methods followed by the mandate review team. The Social Impact section addresses the sixteen criteria contained in section 1(d)(1) of P.A. 09-179. The Financial Impact section addresses the nine criteria contained in section 1(d)(2) of P.A. 09-179. The following table summarizes the expected medical costs of each mandate in this volume for group plans. Medical cost is the primary component of health insurance premiums. See the Ingenix Consulting report (Appendix II) for further details. 2 Summary of Estimated Medical Costs of Mandates in 2010: Volume III Group Plans Per Member Per Month Percent of Mandate (PMPM) Premium Psychotropic Drug Availability $7.50 2.50% Mental or Nervous Conditions $8.50 2.80% Accidental Ingestion or Consumption of Controlled Drug $0.03 0.01% Denial of Coverage Prohibited for Health Care Services to $0.03 0.01% Persons with an Elevated Blood Alcohol Content Treatment of Medical Complications of Alcoholism $0.37 0.10% Occupational Therapy $0.86 0.30% Services of Physician Assistants and Certain Nurses $0.00 0.00% Services Provided by the Veterans’ Home $0.33 0.10% Direct Access to OB/GYNs $0.00 0.00% Chiropractic Services $2.53 0.80% TOTAL $20.15 6.62% 3 Volume III. Table of Contents Chapter I. Psychotropic Drug Availability ...............................................................................................7 Overview ...........................................................................................................................9 Background .....................................................................................................................10 Methods ..........................................................................................................................15 Social Impact...................................................................................................................16 Financial Impact..............................................................................................................22 Chapter 2. Diagnosis and Treatment of Mental or Nervous Conditions .................................................27 Overview .........................................................................................................................29 Background .....................................................................................................................32 Methods ..........................................................................................................................37 Social Impact...................................................................................................................38 Financial Impact..............................................................................................................49 Chapter 3. Accidental Ingestion or Consumption of Controlled Drugs .................................................53 Overview .........................................................................................................................55 Background .....................................................................................................................56 Methods ..........................................................................................................................61 Social Impact...................................................................................................................61 Financial Impact..............................................................................................................68 Chapter 4. Denial of Coverage Prohibited for Health Caare Services to Persons with an Elevated Blood Alcohol Content .............................................................................................................73 Overview .........................................................................................................................75 Background .....................................................................................................................76 Methods ..........................................................................................................................81 Social Impact...................................................................................................................82 Financial Impact..............................................................................................................88 Chapter 5. Treatment of Medical Complications of Alcoholism .............................................................93 Overview .........................................................................................................................95 Background .....................................................................................................................96 Methods ..........................................................................................................................99 Social Impact.................................................................................................................100 Financial Impact............................................................................................................107 Chapter 6. Occupational Therapy ........................................................................................................111 Overview .......................................................................................................................113 Background ...................................................................................................................114
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