(a) The Commissioner of Social Services shall identify geographic areas of the state where competitive bidding for nonemergency transportation services provided to medical assistance recipients to access covered medical services would result in cost savings to the state. For the identified areas, the Commissioner of Social Services, in consultation with the Commissioner of Transportation, the Commissioner of Public Health and the Secretary of the Office of Policy and Management, shall purchase such nonemergency transportation services through a competitive bidding process. Any transportation providers awarded a contract or subcontract for the direct provision of such services shall meet state licensure or certification requirements and the nonemergency transportation requirements established by the Department of Social Services, and shall provide the most cost effective transportation service, provided any contractor awarded a contract solely for coordinating such transportation services shall not be required to meet such licensure or certification requirements and provided the first such contracts for the purchase of such services shall not exceed one year. Prior to awarding a contract pursuant to this section, the Commissioner of Social Services shall consider the effect of the contract on the emergency ambulance primary service areas and volunteer ambulance services affected by the contract. The commissioner may limit the geographic areas to be served by a contractor and may limit the amount of services to be performed by a contractor. The commissioner may operate one or more pilot programs prior to state-wide operation of a competitive bidding program for nonemergency transportation services. By enrolling in the Medicaid program or participating in the competitively bid contract for nonemergency transportation services, providers of nonemergency transportation services agree to offer to recipients of medical assistance all types or levels of transportation services for which they are licensed or certified. Effective October 1, 1991, payment for such services shall be made only for services provided to an eligible recipient who is actually transported. A contract entered into pursuant to this section may include services provided by another state agency. Notwithstanding any provision of the general statutes, a contract entered into pursuant to this section shall establish the rates to be paid for the transportation services provided under the contract. A contract entered into pursuant to this section may include services provided by another state agency and shall supersede any conflicting provisions of the regulations of Connecticut state agencies pertaining to medical transportation services. Any contractor awarded a contract for coordinating nonemergency transportation services for medical assistance recipients, who also coordinates transportation services for nonmedical assistance recipients, shall disclose to any transportation provider, with whom it subcontracts to provide nonemergency transportation services under this section, the source of payment at the time the service is requested.
(b) Notwithstanding any other provision of the general statutes, for purposes of administering medical assistance programs, including, but not limited to, programs administered pursuant to Title XIX or Title XXI of the Social Security Act, the Department of Social Services shall be the sole state agency that sets emergency and nonemergency medical transportation fees or fee schedules for any transportation services that are reimbursed by the department for said medical assistance programs. Effective July 1, 2011, the Commissioner of Social Services shall reduce, by not more than ten per cent, the rates in effect on December 31, 2010, for emergency ambulance transportation fees that are directly reimbursed by the Department of Social Services, provided the commissioner may increase such rates at such time when the commissioner determines there are sufficient funds and a reasonable need for such rate increase.
(P.A. 85-505, S. 12, 21; P.A. 86-403, S. 37, 132; June Sp. Sess. P.A. 91-8, S. 8, 63; P.A. 93-262, S. 1, 87; P.A. 96-268, S. 15, 34; May 9 Sp. Sess. P.A. 02-7, S. 61; P.A. 03-278, S. 64; P.A. 09-210, S. 8; P.A. 11-44, S. 130; 11-61, S. 125.)
History: P.A. 86-403 made technical changes; June Sp. Sess. P.A. 91-8 required that medical transportation service providers offer medical assistance recipients all types and levels of service which are provided, and that payment of services shall only be rendered to providers who transport eligible recipients; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-134s transferred to Sec. 17b-276 in 1995; P.A. 96-268 replaced “medical transportation services” with “nonemergency transportation services”, required consultation with Commissioners of Transportation and Public Health and the Secretary of the Office of Policy and Management, required transportation providers to meet licensure or certification requirements, required commissioner to consider the effect of a contract on the emergency ambulance primary service areas, required transportation providers to agree to offer Medicaid recipients all types of services provided, allowed contracts to include services provided by other state agencies and required contracts to establish rates to be paid for services, effective July 1, 1996; May 9 Sp. Sess. P.A. 02-7 designated existing provisions as Subsec. (a) and amended same by adding provisions re contract may include services provided by another state agency and supersedes any conflicting provisions of medical transportation services regulations, and added Subsec. (b) re exclusive authority of Department of Social Services in setting emergency and nonemergency medical transportation fees for medical assistance programs, effective August 15, 2002; P.A. 03-278 made technical changes in Subsec. (a), effective July 9, 2003; P.A. 09-210 amended Subsec. (a) by adding provision requiring contractors that coordinate nonemergency transportation services for medical assistance recipients and for persons not receiving medical assistance to disclose the source of payment to transportation provider, effective July 1, 2009; P.A. 11-44 amended Subsec. (b) by deleting reference to state-administered general assistance program, effective July 1, 2011; P.A. 11-61 amended Subsec. (b) by adding provision re reduction of rates in effect on December 31, 2010, for emergency ambulance transportation, effective July 1, 2011.
Cited. 233 C. 557.
Structure Connecticut General Statutes
Chapter 319v - Medical Assistance
Section 17b-220. (Formerly Sec. 17-292g). - Reimbursement of medical providers.
Section 17b-221. (Formerly Sec. 17-292h). - Regulations. Reimbursement of hospitals.
Section 17b-221a. - Revenue from Riverview Hospital to be used to pay Medicaid claims.
Section 17b-222. (Formerly Sec. 17-294). - “Humane institution” defined. Daily report.
Section 17b-223. (Formerly Sec. 17-295). - Support in humane institutions.
Section 17b-224. (Formerly Sec. 17-295b). - Liability of patient for per capita cost of care.
Section 17b-225. (Formerly Sec. 17-295c). - Availability of patient information to certain agencies.
Section 17b-226a. - Provider billing rates for goods and services.
Section 17b-227. (Formerly Sec. 17-297). - Payment for services in state humane institutions.
Section 17b-229. (Formerly Sec. 17-299). - Liability for prior charges.
Section 17b-230. (Formerly Sec. 17-300). - Claim of state on death of institution patient.
Section 17b-231. (Formerly Sec. 17-301). - Refund for support of persons in state institutions.
Section 17b-237. (Formerly Sec. 17-310). - State aid toward support of children at center.
Section 17b-238. (Formerly Sec. 17-311). - State payments to hospitals.
Section 17b-239b. - Chronic disease hospitals. Prior authorization procedures. Regulations.
Section 17b-239c. - Interim disproportionate share payments to short-term general hospitals.
Section 17b-239d. - Payments for outpatient hospital services.
Section 17b-239e. - Hospital rate plan. Supplemental pools and payments. Quality measures.
Section 17b-241b. - Rate for private psychiatric residential treatment facilities.
Section 17b-243. (Formerly Sec. 17-313a). - Payments to rehabilitation centers.
Section 17b-245a. - Payments to federally qualified health centers.
Section 17b-245e. - Telehealth services provided under the Medicaid program. Report.
Section 17b-249. (Formerly Sec. 17-317). - Support of mentally ill persons accused of crime.
Section 17b-252. (Formerly Sec. 17-12q). - Connecticut Partnership for Long-Term Care.
Section 17b-256e. - Reports re potential participants in affordable pharmaceutical drug program.
Section 17b-256f. - Eligibility for Medicare savings programs. Regulations.
Section 17b-257b. - Alien eligibility for state medical assistance. Regulations.
Section 17b-257d. - Notice of terminating alien's state medical assistance.
Section 17b-257e. - Postpartum care for women without legal immigration status. Income eligibility.
Section 17b-258. (Formerly Sec. 17-12jj). - Health insurance assistance for unemployed persons.
Section 17b-259. (Formerly Sec. 17-274). - Medically necessary services.
Section 17b-260. (Formerly Sec. 17-134a). - Acceptance of federal grants for medical assistance.
Section 17b-260c. - Medicaid waiver to provide coverage for family planning services.
Section 17b-261. (Formerly Sec. 17-134b). - Medicaid. Eligibility. Assets. Waiver from federal law.
Section 17b-261b. - Program eligibility determined by department. Spousal support.
Section 17b-261c. - Medical assistance. Changes in circumstances.
Section 17b-261d. - Disease management initiative. Implementation. Annual report.
Section 17b-261e. - Mobile field hospital: HUSKY Health program coverage.
Section 17b-261f. - Mobile field hospital account.
Section 17b-261i. - Administrative services for Medicaid recipients. Regulations.
Section 17b-261j. - Easy Breathing model in HUSKY Health program.
Section 17b-261l. - Treatment of reverse annuity mortgage loan proceeds under Medicaid. Regulations.
Section 17b-261o. - Imposition of penalty period when undue hardship exists. Exception.
Section 17b-261t. - Contents of Medicaid benefits cards.
Section 17b-261v. - Parent or needy caretaker relative. Review of Medicaid coverage options.
Section 17b-262. (Formerly Sec. 17-134d). - Regulations. Admissions to nursing home facilities.
Section 17b-263c. - Medical homes. Regulations.
Section 17b-264. (Formerly Sec. 17-134e). - Extension of other public assistance provisions.
Section 17b-265b. - Reimbursement rates for pathologists.
Section 17b-265c. - Medicaid and Medicare dually eligible pilot program.
Section 17b-265g. - Health insurer. Duties owed to the state and Commissioner of Social Services.
Section 17b-266a. - Contract with pharmacy benefits management organization.
Section 17b-268. (Formerly Sec. 17-134i). - Withdrawal of member of group providing services.
Section 17b-269. (Formerly Sec. 17-134j). - Bonding of officers and employees.
Section 17b-270. (Formerly Sec. 17-134k). - Liability of agency and its officers.
Section 17b-271. (Formerly Sec. 17-134l). - Termination of agreement.
Section 17b-272. (Formerly Sec. 17-134m). - Personal fund allowance.
Section 17b-274b. - Pharmaceutical purchasing initiative. Annual report.
Section 17b-274e. - Prescription drugs. Utilization of cost-efficient dosages.
Section 17b-274f. - Step therapy program for Medicaid prescription drugs.
Section 17b-275. (Formerly Sec. 17-134r). - Physician and pharmacy lock-in procedure.
Section 17b-276b. - Nonemergency medical transportation services. Prior authorization.
Section 17b-276c. - Payment for medically necessary mode of transportation service.
Section 17b-277b. - Healthy Start program. Plan. Review.
Section 17b-277c. - Medicaid coverage for donor breast milk. Requirements. Regulations.
Section 17b-278a. - Coverage for treatment for smoking cessation.
Section 17b-278b. - Medical assistance for breast and cervical cancer.
Section 17b-278f. - Amendment to state Medicaid plan to provide treatment for tuberculosis.
Section 17b-278g. - Medical assistance for eyeglasses and contact lenses. Regulations.
Section 17b-278h. - Medical assistance for chiropractic services. Regulations.
Section 17b-278j. - Complex rehabilitation technology. Definitions. Report.
Section 17b-278k. - Electronic transmission of prescriptions for durable medical equipment.
Section 17b-280c. - Methadone maintenance. Minimum rates.
Section 17b-281b. - Used durable medical equipment. Payments to vendors or suppliers.
Section 17b-281c. - Authority of commissioner to modify medical equipment fee schedules.
Section 17b-282b. - Implementation of state-wide dental plan. Waiver.
Section 17b-282c. - Nonemergency dental services. Regulations.
Section 17b-282d. - Commissioner to modify nonemergency dental services. Regulations.
Section 17b-282e. - Orthodontic services for Medicaid recipients under twenty-one years of age.
Section 17b-282f. - Mobile dental clinics. Medicaid coverage areas. Regulations.
Section 17b-284. (Formerly Sec. 17-134ff). - Medical assistance for certain employed persons.
Section 17b-286. - Medicaid management information system. Reports.
Section 17b-288. - Organ transplant account. Regulations.
Section 17b-290. - Definitions.
Section 17b-291. - Children's health insurance plan.
Section 17b-292a. - Information for redetermination of eligibility under HUSKY Plan.
Section 17b-292b. - Prenatal care under HUSKY B. Unborn child option. Income eligibility.
Section 17b-293. - Minimum benefit coverage under HUSKY Plan, Part B.
Section 17b-294. - HUSKY Plus programs.
Section 17b-294a. - HUSKY Plus program. Administration. Eligibility. Regulations.
Section 17b-295. - Cost-sharing requirements under HUSKY B.
Section 17b-297. - Outreach programs for HUSKY Plan, Part A and Part B.
Section 17b-299. - Applications. Approval.
Section 17b-300. - Notification of member's change of circumstance.
Section 17b-301. - Recovery of payment for false statement, misrepresentation or concealment.
Section 17b-303. - Income disregard. Application for federal waiver.
Section 17b-304. - Regulations.
Section 17b-306a. - Child health quality improvement program. Purpose and scope. Annual reports.
Section 17b-307. - Primary care case management pilot program.
Section 17b-311. - Charter Oak Health Plan.
Section 17b-312. - Medicaid waiver to seek federal funds to support the Covered Connecticut program.
Section 17b-313. - Innovation waiver for health care expansion.