CONNECTICUT STATUTES AND CODES
Sec. 20-138b. Interference with choice of physician or optometrist for vision care. Offer by health care center or preferred provider network of ophthalmologic care to include optometric care. Regulat
Sec. 20-138b. Interference with choice of physician or optometrist for vision
care. Offer by health care center or preferred provider network of ophthalmologic
care to include optometric care. Regulations. (a) No person shall interfere with the
exercise by any other person of the person's free choice in the selection of a licensee
under either chapter 370 or this chapter for vision training or care.
(b) If any health care center, as defined in section 38a-175, or preferred provider
network, as defined in section 38a-479aa, offers health care benefits which provide
ophthalmologic care for any person, partnership, corporation, association or group, however organized, such health care center or preferred provider network shall provide
optometric care. If the ophthalmologic care provided may be lawfully rendered by an
optometrist, such health care center or preferred provider network shall provide the
identical eye care coverage and benefits for its members when such care is rendered by
an optometrist under contract with such health care center or preferred provider network.
Such health care center or preferred provider network shall (1) contract with ophthalmologists and optometrists in a manner which will provide fair and sufficient representation
of such providers in relation to the benefits provided by the health care center plan or
preferred provider network, and (2) equally inform its members of the availability of
ophthalmologic and optometric services.
(c) The Insurance Commissioner may adopt regulations, in accordance with chapter
54, to carry out the provisions of subsection (b) of this section.
(1967, P.A. 598; P.A. 79-315; P.A. 80-482, S. 3, 345, 348; P.A. 87-126; P.A. 89-194; P.A. 93-358, S. 2; P.A. 99-284,
S. 49; June Sp. Sess. P.A. 01-4, S. 22, 58.)
History: P.A. 79-315 added Subsecs. (b) and (c) re medical foundations; P.A. 80-482 reinstated insurance commissioner
as department head of independent insurance department rather than as head of division of insurance within the department
of business regulation (successor agency to previously independent insurance department), created by P.A. 77-614; P.A.
87-126 amended Subsec. (b) to require health care centers which provide ophthalmologic care to also provide optometric
care, and deleted Subsec. (c) which had defined "medical foundation"; P.A. 89-194 amended Subsec. (b) to require health
care centers to provide coverage and benefits for eye care lawfully rendered by an optometrist identical to the coverage
and benefits provided for eye care when rendered by an ophthalmologist, to require fair representation of optometrists in
relation to benefits under health care center plan, to require members be equally informed of availability of ophthalmologic
and optometric services and added Subsec. (c) permitting the commissioner to adopt regulations to carry out the provisions
of Subsec. (b); P.A. 93-358 amended Subsec. (b) to include preferred provider networks under the provisions of the Subsec.;
(Revisor's note: In 1997 a reference in Subsec. (c) to "Commissioner of Insurance" was changed editorially by the Revisors
to "Insurance Commissioner" for consistency with customary statutory usage); P.A. 99-284 made technical changes; June
Sp. Sess. P.A. 01-4 amended Subsec. (b) by replacing reference to Sec. 19a-647b with reference to Sec. 38a-479aa and
making technical changes.
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