New London - Lawrence + Memorial Hospital did not need state permission to move outpatient mental health and obstetrics services out of the hospital and into private physicians' offices this fall and winter, but should have obtained state permission before making a management change in 2008.

That's the conclusion reached by the state Office of Health Care Access in response to questions raised about L+M's decision to move the obstetrics clinic from the main hospital to an office at 470 Bank St. in November, and to its January decision to move outpatient psychiatric services from the main hospital to affiliated primary care offices in New London, Niantic, Groton, Pawcatuck and Ledyard.

The private offices where the mental health and obstetrics services are located are part of L+M Physician Association, a hospital affiliate.

In an April 2 letter to L+M, OHCA, which regulates hospitals, noted that the services moved were put under the authority of Associated Specialists of Southeastern Connecticut, another L+M affiliate, in 2008. The state agency said L+M is required to obtain its official permission for the 2008 change but has the authority on its own to move the services from the main hospital to the various private offices.

L+M spokesman Mike O'Farrell said the hospital is preparing a response to OHCA.

j.benson@theday.com