Provider resources
Providers of Distinction
If you are a physician with questions regarding the Provider of Distinction program, please email care.compass@ct.gov.
Providers in Connecticut are identified based on the criteria listed for common medical procedures. Patients in the state’s plan will receive an incentive check when the eligible procedure is complete. Provider of Distinction Program Information & Criteria
To learn more about this program: carecompass.ct.gov/providersofdistinction.
CVS/Caremark Prescription Changes
To help keep prescription copays low, CVS/Caremark updates its Standard Formulary (the “Covered Drug List”) quarterly. This formulary emphasizes clinically effective, lower-cost alternatives to high-cost medications. Additionally, the state contracts with TruDataRx to analyze claims data using Comparative Effectiveness Research (CER) based algorithms to identify formulary opportunities for clinical improvement and cost savings.
When a plan member has one or more prescriptions affected by medication coverage changes, they receive a letter from CVS/Caremark. These letters include information on therapeutically equivalent drugs, the effective date and any associated copayment change information. The patient’s prescriber on file will receive a similar notification.
Additional supportive documentation is posted here:
Healthy Living Programs Offered to State of CT Health Plan Members
State of Connecticut employees, Partnership Plan, and their spouses and dependents
Diabetes Prevention
A 12-month class begins every quarter with educational meetings, coaching and challenges that builds healthy habits to prevent diabetes onset.
Administrator: Wellspark
Eligibility: Members 18+ who are prediabetic determined by fasting glucose A1c &/or taking the CDC Prediabetes risk test. Those with Type 1 or 2 diabetes, are pregnant or have a BMI below 25 are ineligible.
Learn More: carecompass.ct.gov/diabetes
Orthopedic Care
Connect with licensed medical professionals via video chat or phone in under 15 minutes for assistance with chronic musculoskeletal pain or joint mobility and stability issues.
Administrator: Upswing Health
Eligibility: All members. Dependent children under 18 can use Upswing with parental consent and supervision.
Learn More: upswinghealth.com/partner/ct
Diabetes Management and Diabetes Reversal
Diabetes Management Program: Helps type 1 and type 2 diabetics with lifestyle changes and A1c management, providing free monthly test strips.
Diabetes Reversal Program: A virtual clinic for type 2 diabetics, focusing on weight loss, blood sugar reduction, and medication reduction through personalized nutrition plans and support. No medication, surgery, or calorie counting required.
Administrator: Virta Health
Eligibility: Members 18-79. Management Program is for those with either type 1 or 2 diabetes. The Reversal Program is exclusively for those with type 2 diabetes.
Learn More: virtahealth.com/join/soc
Medical Weight Management
Virtual Weight Management
FlyteHealth is a virtual medical weight loss program for those 18 and older that combines medication with lifestyle behavior to help participants improve their health. Learn More
Children’s Weight Management
Connecticut Children’s offers a weight management program for eligible plan members under age 18. Learn More
Important: Medications prescribed for weight loss or weight management are covered only if they are prescribed by a Flyte physician.
Benefits Enrollment