Connecticut General Statutes
Chapter 319v - Medical Assistance
Section 17b-313. - Innovation waiver for health care expansion.

Connecticut General Statutes

Title 17b - Social Services

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-221b. - Federal matching funds for special-education-related services. Portion to be used for 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-226. (Formerly Sec. 17-295d). - Consideration of the costs mandated by collective bargaining agreements.

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-228. (Formerly Sec. 17-298). - Court action by state to recover unpaid portion of charges.

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-232. (Formerly Sec. 17-306). - Payment for board and care in boarding home, group home, chronic and convalescent hospital or other residential facility.

Section 17b-233. (Formerly Sec. 17-307). - Care of handicapped and other children at Newington Children's Hospital. Children with drug-related conditions not to be admitted.

Section 17b-234 and 17b-235. (Formerly Secs. 17-308 and 17-308a). - State payment toward support of patients at Newington Children's Hospital. Payment of retroactive claims.

Section 17b-236. (Formerly Sec. 17-309). - Admission of physically disabled children to The Children's Center.

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-239. (Formerly Sec. 17-312). - Payments to hospitals, emergency department physicians. Value-based methodologies. Readmission penalties. Compliance with federal law. Regulations.

Section 17b-239a. - Payments to short-term general hospitals located in certain distressed municipalities and targeted investment communities with enterprise zones.

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-240. (Formerly Sec. 17-312a). - State payments to hospitals. Rates established by the Office of Health Care Access division of the Department of Public Health.

Section 17b-241. (Formerly Sec. 17-312b). - Payments to mental health and substance abuse residential facilities and freestanding detoxification centers.

Section 17b-241a. - Payments to the Department of Mental Health and Addiction Services for targeted case management services. Submission of expenditures for intensive care management.

Section 17b-241b. - Rate for private psychiatric residential treatment facilities.

Section 17b-242. (Formerly Sec. 17-313). - Payments to home health care agencies and home health aide agencies. Appeals. Hearings. Authorized practitioners. Regulations.

Section 17b-242a. - Prior authorization for Medicaid home health services, physical therapy, occupational therapy and speech therapy. Regulations.

Section 17b-242b. - Pilot program for ventilator-dependent Medicaid recipients receiving medical care at home.

Section 17b-243. (Formerly Sec. 17-313a). - Payments to rehabilitation centers.

Section 17b-244. (Formerly Sec. 17-313b). - Payments to private facilities providing functional or vocational services for severely handicapped persons and payments for residential care. Establishment of rate. Regulations.

Section 17b-244a. - Rates for payment to residential facilities for individuals with intellectual disabilities.

Section 17b-245. (Formerly Sec. 17-313c). - Payments to day care and vocational training programs sponsored by certain associations.

Section 17b-245a. - Payments to federally qualified health centers.

Section 17b-245b. - Federally qualified health centers. Reimbursement methodology in the Medicaid program.

Section 17b-245c. - Demonstration project to provide telemedicine to Medicaid recipients at federally qualified community health centers.

Section 17b-245d. - Information to be provided by federally qualified health centers. Adjustment of encounter rates.

Section 17b-245e. - Telehealth services provided under the Medicaid program. Report.

Section 17b-245f. - Diabetes. Program to recommend federally-qualified health centers and other covered entities. Working group. Medicaid waiver. Report to General Assembly. Regulations.

Section 17b-245g. - Telehealth services under the Connecticut medical assistance program. Audio-only telehealth services. Coverage criteria. Reimbursement.

Section 17b-246. (Formerly Sec. 17-313d). - Rates to include reimbursement for reasonable costs mandated by collective bargaining agreements.

Section 17b-247. (Formerly Sec. 17-314l). - Contracts for stock and standard durable medical equipment. Payment of laboratory services.

Section 17b-248. (Formerly Sec. 17-316). - Liability of home or institution having life care contract.

Section 17b-249. (Formerly Sec. 17-317). - Support of mentally ill persons accused of crime.

Section 17b-250. (Formerly Sec. 17-318). - Payment of hospital expense of inmate transferred from correctional institution.

Section 17b-252. (Formerly Sec. 17-12q). - Connecticut Partnership for Long-Term Care.

Section 17b-253. (Formerly Sec. 17-12r). - Connecticut Partnership for Long-Term Care: Amendments to Medicaid regulations and state plan. Regulations.

Section 17b-254. (Formerly Sec. 17-12s). - Connecticut Partnership for Long-Term Care: Foundation funds and federal approval. Report.

Section 17b-255. (Formerly Sec. 17-12gg). - Insurance assistance for people with AIDS. Managed care insurance program for persons with AIDS.

Section 17b-256. (Formerly Sec. 17-314m). - Prescription drug and insurance assistance program for persons with acquired immunodeficiency syndrome or human immunodeficiency virus. Annual report. Enrollment in Medicare Part D.

Section 17b-256d. - State medical assistance program. Use of federally-qualified community health centers.

Section 17b-256e. - Reports re potential participants in affordable pharmaceutical drug program.

Section 17b-256f. - Eligibility for Medicare savings programs. Regulations.

Section 17b-257a. - Qualified alien eligibility for Medicaid. Medical assistance for certain qualified alien children and pregnant women.

Section 17b-257b. - Alien eligibility for state medical assistance. Regulations.

Section 17b-257c. - Payments to long-term care facilities for care of illegal immigrants admitted to acute care or psychiatric hospitals. Eligibility. 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-259a. - Imposition of cost sharing requirements on recipients of medical assistance. Exception.

Section 17b-259b. - “Medically necessary” and “medical necessity” defined. Notice of denial of services. Regulations.

Section 17b-260. (Formerly Sec. 17-134a). - Acceptance of federal grants for medical assistance.

Section 17b-260a. - Medicaid-financed home and community-based programs for individuals with acquired brain injury. Advisory committee.

Section 17b-260b. - Home and community-based service waivers serving persons with acquired brain injury and persons with intellectual disability. Amendments.

Section 17b-260c. - Medicaid waiver to provide coverage for family planning services.

Section 17b-260d. - Home and community-based services waiver serving persons with acquired immune deficiency syndrome or human immunodeficiency virus.

Section 17b-260e. - Federal funding reductions. Requirements for state to offset Medicaid reductions for family planning services.

Section 17b-261. (Formerly Sec. 17-134b). - Medicaid. Eligibility. Assets. Waiver from federal law.

Section 17b-261a. - Transfer or assignment of assets resulting in the imposition of a penalty period. Return or partial return of asset. Regulations.

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-261g. - Reimbursement under Medicaid program for certain therapy services provided to children by home health care agencies.

Section 17b-261h. - Enrollment of HUSKY A recipients in available employer-sponsored private health insurance. Waiver from federal law. Regulations.

Section 17b-261i. - Administrative services for Medicaid recipients. Regulations.

Section 17b-261j. - Easy Breathing model in HUSKY Health program.

Section 17b-261k. - Protected amount for the community spouse of an institutionalized Medicaid applicant. Regulations.

Section 17b-261l. - Treatment of reverse annuity mortgage loan proceeds under Medicaid. Regulations.

Section 17b-261m. - Administrative services organization. Contract for services. Establishment of rates.

Section 17b-261n. - Coverage for low-income adults under Medicaid program. Amendment to state Medicaid plan to establish alternative benefit package. Waiver application re eligibility and coverage. Regulations.

Section 17b-261o. - Imposition of penalty period when undue hardship exists. Exception.

Section 17b-261p. - Notice re determination of penalty period. Filing claim of undue hardship. Nursing home involvement.

Section 17b-261q. - Action by nursing home facility to collect debt for unpaid care provided during penalty period.

Section 17b-261r. - Determination of applied income. Notice. Action by nursing home facility to recover applied income.

Section 17b-261s. - Copy of complaint, judgment or decree to be mailed in action by nursing home facility.

Section 17b-261t. - Contents of Medicaid benefits cards.

Section 17b-261u. - Alternate coverage after loss of Medicaid eligibility for parent or needy caretaker relative. Review. Quarterly reports.

Section 17b-261v. - Parent or needy caretaker relative. Review of Medicaid coverage options.

Section 17b-261w. - Prior authorization, utilization review criteria for medical assistance. Waivers. Suspensions. Notice requirements.

Section 17b-261x. - Minimum protected resource allowance for community spouse of institutionalized Medicaid recipient.

Section 17b-261y. - Department to compile annual data on denial of Medicaid eligibility in any matter in which Probate Court issued order or decree re assets or income affecting Medicaid eligibility.

Section 17b-262. (Formerly Sec. 17-134d). - Regulations. Admissions to nursing home facilities.

Section 17b-263. (Formerly Sec. 17-274b). - Utilization of outpatient mental health services. Contracts for services. Fee schedule and payment for services.

Section 17b-263a. - Amendment to state Medicaid plan to include assertive community treatment teams and community support services.

Section 17b-263b. - Pilot program for individuals ages nineteen to twenty-one with a mental disorder and chronic health condition. Eligibility.

Section 17b-263c. - Medical homes. Regulations.

Section 17b-264. (Formerly Sec. 17-134e). - Extension of other public assistance provisions.

Section 17b-265. (Formerly Sec. 17-134f). - Department subrogated to right of recovery of applicant or recipient. Utilization of personal health insurance. Insurance coverage of medical assistance recipients. Limitations.

Section 17b-265a. - Physicians providing services to dually eligible Medicaid and Medicare clients. Rates.

Section 17b-265b. - Reimbursement rates for pathologists.

Section 17b-265c. - Medicaid and Medicare dually eligible pilot program.

Section 17b-265d. - Definition of full benefit dually eligible Medicare Part D beneficiary. Prescription drug coverage under Medicare Part D. Copayment coverage. Enrollment in benchmark plan. Commissioner's enrollment authority.

Section 17b-265e. - Medicare Part D Supplemental Needs Fund. Payment by department for nonformulary prescription drugs. Rebates required for pharmaceutical manufacturers. Contracts for supplemental rebates.

Section 17b-265f. - Payment by the department for pharmacy claims. Limitations. Investigation of pharmacy.

Section 17b-265g. - Health insurer. Duties owed to the state and Commissioner of Social Services.

Section 17b-266. (Formerly Sec. 17-134g). - Purchase of insurance. Contracts for comprehensive health care on a prepayment or per capita basis. Certification of providers by commissioner. Payment of capitation claims. Deposit of funds for expenditure...

Section 17b-266a. - Contract with pharmacy benefits management organization.

Section 17b-267. (Formerly Sec. 17-134h). - Use of fiscal intermediaries in connection with medical assistance.

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-273. (Formerly Sec. 17-134o). - Payment rate for ambulance rides eligible under medical assistance program. Payment methodology for ambulance services.

Section 17b-274. (Formerly Sec. 17-134q). - Periodic investigations of pharmacies by Division of Criminal Justice. Brand medically necessary. Procedure for prior approval to dispense brand name drug. Disclosure.

Section 17b-274a. - Maximum allowable costs for generic prescription drugs. Implementation of maximum allowable cost list.

Section 17b-274b. - Pharmaceutical purchasing initiative. Annual report.

Section 17b-274c. - Voluntary mail order option for maintenance prescription drugs and drugs covered under the Medicare Part D program.

Section 17b-274d. - Pharmaceutical and Therapeutics Committee. Membership. Duties. Preferred drug lists. Automatic refill recommendations. Supplemental rebates. Administrative hearings.

Section 17b-274e. - Prescription drugs. Utilization of cost-efficient dosages.

Section 17b-274f. - Step therapy program for Medicaid prescription drugs.

Section 17b-274g. - Preferred drug list purchases. Prohibition on Medicaid cost sharing. Reporting, notice requirements for other Medicaid cost-sharing requirements.

Section 17b-274h. - Auto refills of prescription drugs covered under Medicaid. Limitations. Legislative review process.

Section 17b-275. (Formerly Sec. 17-134r). - Physician and pharmacy lock-in procedure.

Section 17b-276. (Formerly Sec. 17-134s). - Competitive bidding process for nonemergency transportation services. Disclosure of payment source. Fee schedules.

Section 17b-276a. - Amendment to Medicaid state plan to reduce expenditures for Medicaid nonemergency medical transportation. Limitations.

Section 17b-276b. - Nonemergency medical transportation services. Prior authorization.

Section 17b-276c. - Payment for medically necessary mode of transportation service.

Section 17b-277. (Formerly Sec. 17-134u). - Medicaid for pregnant women. Presumptive Medicaid eligibility for pregnant women and newborn children. Postpartum care.

Section 17b-277a. - Program to inform applicants to the Healthy Start program of services provided by the Connecticut Home Visiting System.

Section 17b-277b. - Healthy Start program. Plan. Review.

Section 17b-277c. - Medicaid coverage for donor breast milk. Requirements. Regulations.

Section 17b-278. (Formerly Sec. 17-134z). - Home leave absences for certain medical assistance recipients.

Section 17b-278a. - Coverage for treatment for smoking cessation.

Section 17b-278b. - Medical assistance for breast and cervical cancer.

Section 17b-278c. - Amendment to state Medicaid plan to provide mammogram examinations to certain women.

Section 17b-278d. - Amendment to state Medicaid plan and state children's health insurance plan to provide neuropsychological testing for children diagnosed with cancer.

Section 17b-278e. - Amendment to state Medicaid plan to exclude payment for hospital-acquired conditions.

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-278i. - Medical assistance for customized wheelchairs. Repairs. Refurbished equipment, parts and components. Regulations.

Section 17b-278j. - Complex rehabilitation technology. Definitions. Report.

Section 17b-278k. - Electronic transmission of prescriptions for durable medical equipment.

Section 17b-279. (Formerly Sec. 17-134aa). - Medicaid prescription drug utilization review. Erectile dysfunction drugs. Prior authorization requirement and coverage limitation. Report.

Section 17b-280. (Formerly Sec. 17-134bb). - Reimbursement rate for covered outpatient drugs under the Medicaid program.

Section 17b-280a. - Payment for over-the-counter medications under medical assistance program. Exceptions.

Section 17b-280b. - Proposed revisions to reimbursement methodology for covered outpatient drugs under the Medicaid program. Legislative review.

Section 17b-280c. - Methadone maintenance. Minimum rates.

Section 17b-281. (Formerly Sec. 17-134cc). - Payment of oxygen products and services under medical assistance program.

Section 17b-281a. - Procedure for preauthorization of purchase or rental of durable medical equipment.

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-282. (Formerly Sec. 17-134dd). - Medical assistance for certain children and elderly and disabled persons.

Section 17b-282a. - Coverage for in-patient dental services in certain instances involving children and developmentally disabled persons.

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-283. (Formerly Sec. 17-134ee). - Medicaid home and community-based services waiver program for children and young adults with disabilities.

Section 17b-283a. - Active duty armed forces member application for Medicaid home or community-based program on behalf of eligible spouse or child.

Section 17b-284. (Formerly Sec. 17-134ff). - Medical assistance for certain employed persons.

Section 17b-285. (Formerly Sec. 17-134gg). - Assignment of spousal support of an institutionalized person or person in need of institutional care.

Section 17b-286. - Medicaid management information system. Reports.

Section 17b-287. (Formerly Sec. 17-292a). - Assistance for person who needs hospitalization and is not a resident of any town.

Section 17b-288. - Organ transplant account. Regulations.

Section 17b-289. - Short title: HUSKY and HUSKY Plus Act. HUSKY Plan, Part A and HUSKY Plan, Part B participants.

Section 17b-290. - Definitions.

Section 17b-291. - Children's health insurance plan.

Section 17b-292. - HUSKY B. Eligibility. Expedited eligibility under HUSKY B. Presumptive eligibility under Medicaid. State-funded coverage for certain children not otherwise covered. Postpartum care.

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-296. - Provision for clinicians in managed care plans. Provision by managed care organizations of services under HUSKY Plan.

Section 17b-297. - Outreach programs for HUSKY Plan, Part A and Part B.

Section 17b-297a. - Funds to promote enrollment of children eligible for other income-based assistance programs in HUSKY B.

Section 17b-297b. - Procedures for sharing information in applications for school lunch program for purpose of determining eligibility under HUSKY Health program.

Section 17b-298. - Regulations re quality of care under HUSKY Plan. Outcome criteria. Sanctions. Reports re HUSKY Plans to General Assembly.

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-301a to 17b-301p. - Prohibited acts re medical assistance: Definitions. Prohibited acts re medical assistance; penalties. Attorney General's investigation of prohibited acts; civil action. Civil action by individual; consent for withdrawa...

Section 17b-302. - Public involvement in design and implementation of HUSKY Plan, Part B. Submission of plan for public involvement to General Assembly.

Section 17b-303. - Income disregard. Application for federal waiver.

Section 17b-304. - Regulations.

Section 17b-306. - Plan for a system of preventive health services for children in the HUSKY Health program.

Section 17b-306a. - Child health quality improvement program. Purpose and scope. Annual reports.

Section 17b-307. - Primary care case management pilot program.

Section 17b-307a. - Medicaid reimbursement system incentivizing collaboration between primary care providers and behavioral and mental health care providers for HUSKY Health program members.

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.

Section 17b-314 to 17b-319. - Reserved for future use.