Sec.38a-472f-4. Minimum Standards for Provider Directories

Each health carrier that delivers, issues for delivery, renews, amends or continues any individual or group health insurance policy or certificate in this state that uses a provider network shall:

(1) Post an on-line provider directory in searchable format for each provider network that is made available in the state;

(2) Clearly label the provider network so it may be linked to a specific plan offered;

(3) Update the on-line provider directory no less than monthly;

(4) Make the provider directory accessible to both members and non-members;

(5) State the date the provider directory was last updated;

(6) Make a hard copy of the provider directory, that is updated no less than annually, available upon request;

(7) Provide an e-mail address and telephone number to report inaccurate information;

(8) Indicate whether each participating provider listed in the provider directory accepts new patients, and whether such health care provider is accepting new patients on an outpatient services basis;

(9) Indicate the languages spoken in each participating provider’s office or facility;

(10) Indicate whether each participating provider’s office or facility is handicapped accessible;

(11) Indicate the participating providers for each different tier of benefits, if applicable;

(12) Establish and maintain an audit process to ensure accuracy of provider directories;

(13) Ensure the provider directory accommodates the communication needs of individuals with disabilities or limited English proficiency and provides information on how to receive assistance;

(14) Provide by type, for participating facilities other than hospitals, the facility name, the type, the types of health care services performed at the facility and the facility's location and telephone number;

(15) Provide, for each participating facility that is a hospital, the hospital name, the type (such as acute, rehabilitation, children's or cancer), location and telephone number;

(16) Provide, for each participating health care provider, the health care provider's name, contact information, specialty (if applicable) and participating office location or locations;

(17) Indicate whether participating health care providers are authorized to admit patients to hospitals participating in the network; and

(18) Indicate whether hospital-based health care providers are participating providers and see patients on an outpatient service basis.

(Effective July 2, 2018)