# Conn. Gen. Stat. § 38a-472g: Sec. 38a-472g. Restrictions applicable to prior authorization or precertification

> Connecticut · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472g

## Section

- **Citation:** Conn. Gen. Stat. § 38a-472g
- **Heading:** Sec. 38a-472g. Restrictions applicable to prior authorization or precertification
- **Jurisdiction:** Connecticut
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Connecticut Code / Title 38a / Chapter 700c / Section 38a-472g

## Text

(A) Such insurer, center, society, corporation, entity or company failed to notify the insured's or enrollee's health care provider at least three business days prior to the scheduled date of such admission, service, procedure or extension of stay that such prior authorization or precertification has been reversed or rescinded on the basis of medical necessity, fraud or lack of coverage; and

(B) Such admission, service, procedure or extension of stay has taken place in reliance on such prior authorization or precertification.

(2) The provisions of this subsection shall apply regardless of whether such prior authorization or precertification is required or is requested by an insured's or enrollee's health care provider. Unless reversed or rescinded as set forth in subparagraph (A) of subdivision (1) of this subsection, such prior authorization or precertification shall be effective for not less than sixty days from the date of issuance.

(b) Nothing in subsection (a) of this section shall be construed to authorize benefits or services in excess of those that are provided for in the insured's or enrollee's policy or contract.

(c) Nothing in subsection (a) of this section shall affect the provisions of subsection (b) of section 38a-479b .

## Nearby sections

- [Conn. Gen. Stat. § 38a-470 Sec. 38a-470. (Formerly Sec. 38-174n). Lien on workers' compensation awards for insurers. Notice of lien.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-470.md)
- [Conn. Gen. Stat. § 38a-471 Sec. 38a-471. (Formerly Sec. 38-174o). Third party prescription programs. Notice of cancellation. Applicability of section.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-471.md)
- [Conn. Gen. Stat. § 38a-472 Sec. 38a-472. (Formerly Sec. 38-174a). Assignment of insurance proceeds to doctor, hospital or state agency. Lien for state care. Notice of lien.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472.md)
- [Conn. Gen. Stat. § 38a-472c Sec. 38a-472c. Dental policies. Estimate of reimbursement. Material adjustments to fee schedules for in-network providers. Notice.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472c.md)
- [Conn. Gen. Stat. § 38a-472d Sec. 38a-472d. Public education outreach program re health insurance availability and eligibility requirements.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472d.md)
- [Conn. Gen. Stat. § 38a-472f Sec. 38a-472f. Network adequacy. Health carrier duties and responsibilities. Access plan filing.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472f.md)
- [Conn. Gen. Stat. § 38a-472g Sec. 38a-472g. Restrictions applicable to prior authorization or precertification.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472g.md)
- [Conn. Gen. Stat. § 38a-472h Sec. 38a-472h. Fees charged by dentists, optometrists and ophthalmologists for noncovered benefits. Notice and posting required.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472h.md)
- [Conn. Gen. Stat. § 38a-472i Sec. 38a-472i. Payment amount of professional services component of covered colonoscopy or endoscopic services.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472i.md)
- [Conn. Gen. Stat. § 38a-472j Sec. 38a-472j. Restrictions applicable to cost-sharing for covered benefits. Regulations.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472j.md)
- [Conn. Gen. Stat. § 38a-472l Sec. 38a-472l. Participating dental provider contracts. Third-party access. Restrictions. Exceptions.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472l.md)
- [Conn. Gen. Stat. § 38a-473 Sec. 38a-473. Medicare supplement expense factors. Age, gender, previous claim or medical history rating prohibited.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-473.md)
- [Conn. Gen. Stat. § 38a-474 Sec. 38a-474. Medicare supplement policy rate increases: Procedure. Age, gender, previous claim or medical history rating prohibited.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-474.md)
- [Conn. Gen. Stat. § 38a-475 Sec. 38a-475. Precertification of long-term care policies under the Connecticut Partnership for Long-Term Care. Regulations.](https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-475.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_CT_T38a_C700c_S38a-472g. Check the current official text before relying on it. Not legal advice.