Continuity of Care

The Report Card examines whether states have continuity of care provisions which protect patients from disruptions in care due to a change in plan or a change in a provider's network status. These provisions are particularly important for pregnant women and patients with chronic, long-term or terminal illnesses.

  • Continuity of Care

      Strength Of Policy 2007 Change From 2004
    ALABAMA Limited Policy Same
    ALASKA Limited Policy Worse
    ARIZONA Limited Policy Same
    ARKANSAS Limited Policy Same
    CALIFORNIA Meets Policy Same
    COLORADO Limited Policy Same
    CONNECTICUT No/Harmful Policy Same
    DELAWARE Meets Policy Same
    DISTRICT OF COLUMBIA No/Harmful Policy Same
    FLORIDA Meets Policy Same
    GEORGIA No/Harmful Policy Worse
    HAWAII No/Harmful Policy Same
    IDAHO No/Harmful Policy Same
    ILLINOIS Limited Policy Same
    INDIANA Limited Policy Same
    IOWA Limited Policy Same
    KANSAS Limited Policy Same
    KENTUCKY Limited Policy Same
    LOUISIANA Limited Policy Better
    MAINE Meets Policy Same
    MARYLAND Limited Policy Same
    MASSACHUSETTS Limited Policy Same
    MICHIGAN Limited Policy Same
    MINNESOTA Limited Policy Same
    MISSISSIPPI No/Harmful Policy Same
    MISSOURI Meets Policy Same
    MONTANA No/Harmful Policy Same
    NEBRASKA No/Harmful Policy Same
    NEVADA No/Harmful Policy Same
    NEW HAMPSHIRE Limited Policy Same
    NEW JERSEY Meets Policy Same
    NEW MEXICO No/Harmful Policy Same
    NEW YORK Meets Policy Same
    NORTH CAROLINA Meets Policy Same
    NORTH DAKOTA No/Harmful Policy Same
    OHIO No/Harmful Policy Same
    OKLAHOMA Limited Policy Same
    OREGON Meets Policy Better
    PENNSYLVANIA Meets Policy Same
    RHODE ISLAND No/Harmful Policy Same
    SOUTH CAROLINA Limited Policy Same
    SOUTH DAKOTA Meets Policy Same
    TENNESSEE Meets Policy Same
    TEXAS Meets Policy Better
    UTAH No/Harmful Policy Same
    VERMONT Limited Policy Same
    VIRGINIA Meets Policy Better
    WASHINGTON Limited Policy Same
    WEST VIRGINIA Limited Policy Same
    WISCONSIN Meets Policy Same
    WYOMING No/Harmful Policy Same
     
    Meets PolicyMeets Policy 15  
    Limited PolicyLimited Policy 21  
    Weak PolicyWeak Policy 0  
    No/Harmful PolicyNo/Harmful Policy 15  
    Better Better 4  
    Worse Worse 2  
    Same Same 45  

    Does the state have “continuity of care” provisions?

    States receive a "meets policy" when they require plans to cover continued care from the provider a) for at least 60 days; b) if the patient is in her second trimester of pregnancy and has begun prenatal care with the provider; and c) if the patient is in a current course of treatment or if the treatment is medically necessary.  The definition of medically necessary includes those provisions in the law that reference specific circumstances such as chronic conditions and degenerative conditions. If the law defines medically necessary as only referring to terminal illnesses, then the state does not satisfy the medically necessary criterion.  States receive a "limited policy" when they have at least one of these provisions in place and a "no policy" if they have none of these protections.

    Data Source: Continuity of Care, 2006.

    The Henry J. Kaiser Family Foundation,  "State Mandated Benefits: Continuity of Care, 2006," available at http://www.statehealthfacts.org/comparetable.jsp?cat=7&ind=374, accessed March 30, 2007.