Sec. 38a-524. Coverage for occupational therapy. Definitions. Benefits.

      Sec. 38a-524. Coverage for occupational therapy. Definitions. Benefits. (a) For the purposes of this section:

      (1) "Occupational therapy" means services provided by a licensed occupational therapist in accordance with a plan of care established and approved in writing by a physician licensed in accordance with the provisions of chapter 370, who has certified that the prescribed care and treatment are not available from sources other than a licensed occupational therapist and which are provided in private practice or in a licensed health care facility. Such plan shall be reviewed and certified at least every two months by such physician.

      (2) "Health care facility" means an institution which provides occupational therapy, including, but not limited to, an outpatient clinic, a rehabilitative agency and a skilled or intermediate nursing facility.

      (3) "Rehabilitative agency" means an agency which provides an integrated multitreatment program designed to upgrade the function of handicapped disabled individuals by bringing together, as a team, specialized personnel from various allied health fields.

      (4) "Partial hospitalization" means a formal program of care provided in a hospital or facility for periods of less than twenty-four hours a day.

      (b) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (6), (11) and (12) of section 38a-469 delivered, issued for delivery or renewed in this state on or after October 1, 1982, which provides coverage for expenses incurred for physical therapy shall provide coverage for occupational therapy provided in private practice or in a health care facility or in a partial hospitalization program on an exchange basis.

      (P.A. 90-243, S. 108.)

      See Sec. 38a-496 for similar provisions re individual policies.