Important State of Connecticut Employer Group, Connecticut Partnership Plan changes

Effective January 1, 2024, prior authorization (PA) requirements will change for members of the State of Connecticut Employer Group and Connecticut Partnership plans.

For the medical code categories listed below, care providers will no longer be required to obtain a prior authorization effective January 1, 2024:

• CT scan
• MLST (multi-level sleep study)
• Polysomnography, home sleep study, and home portable monitors
• Echocardiograms
• SPECT scan
• Wound care
• Knee visco supplementation with hyaluronic acid

Prior authorization/fertility

Quantum Health, Inc. will process PA requests for fertility services. For a PA request to be considered eligible for approval, a yes answer must be provided to at least one of the following questions:

1. Does the member have an infertility diagnosis?
2. Is the member unable to achieve a pregnancy as an individual or with a partner because the individual or couple does not have the necessary gametes to achieve a pregnancy?

Care providers may call the number listed on the back of their patient’s member ID card for assistance with these detailed PA requirements.

We continue to work towards identifying simplified ways to access care.