Update on referral requirement for home health agency care

In the November 2024 issue of Provider Update, CarePartners of Connecticut announced a number of benefit changes for the 2025 plan year, including a new requirement that referrals be obtained for home health agency care for out-of-network providers for CarePartners CareAdvantage Preferred HMO members.

We want to offer an update concerning this change: In response to feedback from our provider partners, effective for dates of service beginning June 15, 2025 a provider/discharging facility order will satisfy this referral requirement. No additional referral from the patient’s primary care physician will be needed to initiate home health agency care.

CarePartners of Connecticut aims to provide our members with the best care in the most appropriate setting while minimizing any unnecessary administrative burden on the providers in our network who deliver that care. We hope this update helps to alleviate concerns and better facilitate efficient coordination of care processes.