CONNECTICUT - REFERRALS

March 14, 2008

State laws and regulations that affect your medical practice

I. CONSULTING PHYSICIANS FROM ANOTHER STATE

1. May a physician request a consultation from a physician licensed in another state?

Yes. The rendering of an occasional medical service by a physician from another state which is incidental to a special case may be permitted, under limited circumstances. However, Connecticut restricts the circumstances for in-state medical practice by a physician not licensed in this state.

The limited circumstances are as follows:

A. An out-of-state physician may provide consultations, on an irregular basis, to a Connecticut licensed physician if he is employed to do so.

B. A physician or surgeon residing outside of Connecticut who holds a current license in good standing in another state may, in relation to a patient residing in Connecticut, treat operate or prescribe for any injury, deformity, ailment or disease provided such physician or surgeon may practice in Connecticut without a State license for a period not to exceed thirty (30) consecutive days.

C.G.S.A. § 20-9

C. Any physician licensed or otherwise authorized to practice medicine by the armed forces of the United States may practice as a physician without a license in a free clinic in Connecticut provided:

1. the physician does not receive payment for such practice; and

2. the physician carries, either directly or through the clinic, professional liability insurance or indemnity against liability for professional malpractice equal to or greater than that required of state-licensed.

C.G.S.A. § 20-12

II. SELF-REFERRALS

1. What are the regulations governing the referral of patients by a physician to health care facilities in which the physician has a financial interest?

A. Disclosure.

A physician who has an ownership or investment interest in an entity that provides diagnostic or therapeutic services, or receives compensation or remuneration for referral of patients to an entity that provides diagnostic or therapeutic services shall disclose such interest to any patient prior to referring such patient to such entity for diagnostic or therapeutic services and provide reasonable referral alternatives. This information must be verbally disclosed to each patient or posted in a conspicuous place visible to patients in the practitioner's office. The posted information shall list the therapeutic and diagnostic services from which the practitioner has an ownership or investment interest and diagnostic services from which the practitioner receives compensation or remuneration for referrals and state that alternate referrals will be made upon request.

B. Therapeutic Services.

Therapeutic services are defined to include physical therapy, radiation therapy, intravenous therapy and rehabilitation services. Rehabilitation services include physical therapy, occupational therapy, speech and language pathology, or any combination of these services.

C. Ownership Interest.

The definition of “ownership or investment interest in an entity that provides diagnostic or therapeutic services,” as it relates to physicians who have such ownership interest in an entity, does not include ownership of investment securities that are purchased by the practitioner on terms available to the general public and are publicly traded. The scope of the term “an entity that provides diagnostic or therapeutic services" includes services provided by an entity that is within a hospital but is not owned by the hospital.

D. In-office Ancillary Services.

This disclosure requirement does not apply to in-office ancillary services.

C.G.S.A. § 20-7a

E. Workers Compensation.

Physicians may not refer workers' compensation patients for physical therapy or diagnostic testing to a facility in which they have an ownership or investment interest other than ownership of investment securities purchased by the physician on terms available to the general public and which are publicly traded.

CT ADC § 31-280-1

Copyright © Kern Augustine Conroy and Schoppmann, P.C. Used with permission.

Updated 2008