[§431:10H-219]  Minimum standards for home
health and community care benefits.  (a)  A long-term care insurance policy
or certificate shall not, if it provides benefits for home health care or
community care services, limit or exclude benefits by:



(1)  Requiring that the insured or claimant would need
care in a skilled nursing facility if home health care services were not
provided;



(2)  Requiring that the insured or claimant first or
simultaneously receive nursing or therapeutic services, or both, in a home,
community, or institutional setting before home health care services are
covered;



(3)  Limiting eligible services to services provided
by registered nurses or licensed practical nurses;



(4)  Requiring that a nurse or therapist provide
services covered by the policy that can be provided by a home health aide, or
other licensed or certified home care worker acting within the scope of the
person's licensure or certification;



(5)  Excluding coverage for personal care services
provided by a home health aide;



(6)  Requiring that the provision of home health care
services be at a level of certification or licensure greater than that required
by the eligible service;



(7)  Requiring that the insured or claimant have an
acute condition before home health care services are covered;



(8)  Limiting benefits to services provided by
medicare-certified agencies or providers; or



(9)  Excluding coverage for adult day care service.



(b)  A long-term care insurance policy or
certificate, if it provides for home health or community care services, shall
provide total home health or community care coverage that is a dollar amount
equivalent to at least one-half of one year's coverage available for nursing
home benefits under the policy or certificate, at the time covered home health
or community care services are being received.  This requirement shall not
apply to policies or certificates issued to residents of continuing care
retirement communities.



(c)  Home health care coverage may be applied
to nonhome health care benefits provided in the policy or certificate when
determining maximum coverage under the terms of the policy or certificate. [L
1999, c 93, pt of §2]