Chapter 319v. Medical Assistance
Section
17b-220(Formerly Sec. 17-292g). Reimbursement of medical providers.17b-221(Formerly Sec. 17-292h). Regulations. Reimbursement of hospitals.17b-221aRevenue from Riverview Hospital to be used to pay Medicaid claims.17b-221bFederal matching funds for special-education-related services. Portion to be used for Medicaid claims.17b-222(Formerly Sec. 17-294). “Humane institution” defined. Daily report.17b-223(Formerly Sec. 17-295). Support in humane institutions.17b-224(Formerly Sec. 17-295b). Liability of patient for per capita cost of care.17b-225(Formerly Sec. 17-295c). Availability of patient information to certain agencies.17b-226(Formerly Sec. 17-295d). Consideration of the costs mandated by collective bargaining agreements.17b-226aProvider billing rates for goods and services.17b-227(Formerly Sec. 17-297). Payment for services in state humane institutions.17b-228(Formerly Sec. 17-298). Court action by state to recover unpaid portion of charges. Limitation on recovery of charges from estate of deceased former humane institution patient.17b-229(Formerly Sec. 17-299). Liability for prior charges.17b-230(Formerly Sec. 17-300). Claim of state on death of institution patient. Limitation on recovery.17b-231(Formerly Sec. 17-301). Refund for support of persons in state institutions.17b-232(Formerly Sec. 17-306). Payment for board and care in boarding home, group home, chronic and convalescent hospital or other residential facility.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.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.17b-236(Formerly Sec. 17-309). Admission of physically disabled children to The Children's Center.17b-237(Formerly Sec. 17-310). State aid toward support of children at center.17b-238(Formerly Sec. 17-311). State payments to hospitals.17b-239(Formerly Sec. 17-312). Payments to hospitals, emergency department physicians. Value-based methodologies. Readmission penalties. Compliance with federal law. Regulations.17b-239aPayments to short-term general hospitals located in certain distressed municipalities and targeted investment communities with enterprise zones.17b-239bChronic disease hospitals. Prior authorization procedures. Regulations.17b-239cInterim disproportionate share payments to short-term general hospitals.17b-239dPayments for outpatient hospital services.17b-239eHospital rate plan. Supplemental pools and payments. Quality measures.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.17b-241(Formerly Sec. 17-312b). Payments to mental health and substance abuse residential facilities and freestanding detoxification centers.17b-241aPayments to the Department of Mental Health and Addiction Services for targeted case management services. Submission of expenditures for intensive care management.17b-241bRate for private psychiatric residential treatment facilities.17b-242(Formerly Sec. 17-313). Payments to home health care agencies and home health aide agencies. Appeals. Hearings. Authorized practitioners. Regulations.17b-242aPrior authorization for Medicaid home health services, physical therapy, occupational therapy and speech therapy. Regulations.17b-242bPilot program for ventilator-dependent Medicaid recipients receiving medical care at home.17b-243(Formerly Sec. 17-313a). Payments to rehabilitation centers.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.17b-244aRates for payment to residential facilities for individuals with intellectual disabilities.17b-245(Formerly Sec. 17-313c). Payments to day care and vocational training programs sponsored by certain associations.17b-245aPayments to federally qualified health centers.17b-245bFederally qualified health centers. Reimbursement methodology in the Medicaid program.17b-245cDemonstration project to provide telemedicine to Medicaid recipients at federally qualified community health centers.17b-245dInformation to be provided by federally qualified health centers. Adjustment of encounter rates.17b-245eTelehealth services provided under the Medicaid program. Report.17b-245fDiabetes. Program to recommend federally-qualified health centers and other covered entities. Working group. Medicaid waiver. Report to General Assembly. Regulations.17b-245gTelehealth services under the Connecticut medical assistance program. Audio-only telehealth services. Coverage criteria. Reimbursement.17b-246(Formerly Sec. 17-313d). Rates to include reimbursement for reasonable costs mandated by collective bargaining agreements.17b-247(Formerly Sec. 17-314l). Contracts for stock and standard durable medical equipment. Payment of laboratory services.17b-248(Formerly Sec. 17-316). Liability of home or institution having life care contract.17b-249(Formerly Sec. 17-317). Support of mentally ill persons accused of crime.17b-250(Formerly Sec. 17-318). Payment of hospital expense of inmate transferred from correctional institution.17b-25117b-25117b-252(Formerly Sec. 17-12q). Connecticut Partnership for Long-Term Care.17b-253(Formerly Sec. 17-12r). Connecticut Partnership for Long-Term Care: Amendments to Medicaid regulations and state plan. Regulations.17b-254(Formerly Sec. 17-12s). Connecticut Partnership for Long-Term Care: Foundation funds and federal approval. Report.17b-255(Formerly Sec. 17-12gg). Insurance assistance for people with AIDS. Managed care insurance program for persons with AIDS.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.17b-256a to 17b-256c17b-256a to 17b-256c17b-256dState medical assistance program. Use of federally-qualified community health centers.17b-256eReports re potential participants in affordable pharmaceutical drug program.17b-256fEligibility for Medicare savings programs. Regulations.17b-257(Formerly Sec. 17-12ii).17b-257aQualified alien eligibility for Medicaid. Medical assistance for certain qualified alien children and pregnant women.17b-257bAlien eligibility for state medical assistance. Regulations.17b-257cPayments to long-term care facilities for care of illegal immigrants admitted to acute care or psychiatric hospitals. Eligibility. Regulations.17b-257dNotice of terminating alien's state medical assistance.17b-257ePostpartum care for women without legal immigration status. Income eligibility.17b-258(Formerly Sec. 17-12jj). Health insurance assistance for unemployed persons.17b-259(Formerly Sec. 17-274). Medically necessary services.17b-259aImposition of cost sharing requirements on recipients of medical assistance. Exception.17b-259b“Medically necessary” and “medical necessity” defined. Notice of denial of services. Regulations.17b-260(Formerly Sec. 17-134a). Acceptance of federal grants for medical assistance.17b-260aMedicaid-financed home and community-based programs for individuals with acquired brain injury. Advisory committee.17b-260bHome and community-based service waivers serving persons with acquired brain injury and persons with intellectual disability. Amendments.17b-260cMedicaid waiver to provide coverage for family planning services.17b-260dHome and community-based services waiver serving persons with acquired immune deficiency syndrome or human immunodeficiency virus.17b-260eFederal funding reductions. Requirements for state to offset Medicaid reductions for family planning services.17b-261(Formerly Sec. 17-134b). Medicaid. Eligibility. Assets. Waiver from federal law. State-funded medical assistance for children regardless of immigration status.17b-261aTransfer or assignment of assets resulting in the imposition of a penalty period. Return or partial return of asset. Regulations.17b-261bProgram eligibility determined by department. Spousal support.17b-261cMedical assistance. Changes in circumstances.17b-261dDisease management initiative. Implementation. Annual report.17b-261eMobile field hospital: HUSKY Health program coverage.17b-261fMobile field hospital account.17b-261gReimbursement under Medicaid program for certain therapy services provided to children by home health care agencies.17b-261hEnrollment of HUSKY A recipients in available employer-sponsored private health insurance. Waiver from federal law. Regulations.17b-261iAdministrative services for Medicaid recipients. Regulations.17b-261jEasy Breathing model in HUSKY Health program.17b-261kProtected amount for the community spouse of an institutionalized Medicaid applicant. Regulations.17b-261lTreatment of reverse annuity mortgage loan proceeds under Medicaid. Regulations.17b-261mAdministrative services organization. Contract for services. Establishment of rates.17b-261nCoverage for low-income adults under Medicaid program. Amendment to state Medicaid plan to establish alternative benefit package. Waiver application re eligibility and coverage. Regulations.17b-261oImposition of penalty period when undue hardship exists. Exception.17b-261pNotice re determination of penalty period. Filing claim of undue hardship. Nursing home involvement.17b-261qAction by nursing home facility to collect debt for unpaid care provided during penalty period.17b-261rDetermination of applied income. Notice. Action by nursing home facility to recover applied income.17b-261sCopy of complaint, judgment or decree to be mailed in action by nursing home facility.17b-261tContents of Medicaid benefits cards.17b-261uAlternate coverage after loss of Medicaid eligibility for parent or needy caretaker relative. Review. Quarterly reports.17b-261vParent or needy caretaker relative. Review of Medicaid coverage options.17b-261wPrior authorization, utilization review criteria for medical assistance. Waivers. Suspensions. Notice requirements.17b-261xMinimum protected resource allowance for community spouse of institutionalized Medicaid recipient.17b-261yDepartment 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.17b-262(Formerly Sec. 17-134d). Regulations. Admissions to nursing home facilities.17b-263(Formerly Sec. 17-274b). Utilization of outpatient mental health services. Contracts for services. Fee schedule and payment for services.17b-263aAmendment to state Medicaid plan to include assertive community treatment teams and community support services.17b-263bPilot program for individuals ages nineteen to twenty-one with a mental disorder and chronic health condition. Eligibility.17b-263cMedical homes. Regulations.17b-264(Formerly Sec. 17-134e). Extension of other public assistance provisions.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. Allocation of child support obligor funds.17b-265aPhysicians providing services to dually eligible Medicaid and Medicare clients. Rates.17b-265bReimbursement rates for pathologists.17b-265cMedicaid and Medicare dually eligible pilot program.17b-265dDefinition 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.17b-265eMedicare Part D Supplemental Needs Fund. Payment by department for nonformulary prescription drugs. Rebates required for pharmaceutical manufacturers. Contracts for supplemental rebates.17b-265fPayment by the department for pharmacy claims. Limitations. Investigation of pharmacy.17b-265gHealth insurer. Duties owed to the state and Commissioner of Social Services.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 expenditures for children's health programs and services.17b-266aContract with pharmacy benefits management organization.17b-267(Formerly Sec. 17-134h). Use of fiscal intermediaries in connection with medical assistance.17b-268(Formerly Sec. 17-134i). Withdrawal of member of group providing services.17b-269(Formerly Sec. 17-134j). Bonding of officers and employees.17b-270(Formerly Sec. 17-134k). Liability of agency and its officers.17b-271(Formerly Sec. 17-134l). Termination of agreement.17b-272(Formerly Sec. 17-134m). Personal fund allowance.17b-273(Formerly Sec. 17-134o). Payment rate for ambulance rides eligible under medical assistance program. Payment methodology for ambulance services.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.17b-274aMaximum allowable costs for generic prescription drugs. Implementation of maximum allowable cost list.17b-274bPharmaceutical purchasing initiative. Annual report.17b-274cVoluntary mail order option for maintenance prescription drugs and drugs covered under the Medicare Part D program.17b-274dPharmaceutical and Therapeutics Committee. Membership. Duties. Preferred drug lists. Automatic refill recommendations. Supplemental rebates. Administrative hearings.17b-274ePrescription drugs. Utilization of cost-efficient dosages.17b-274fStep therapy program for Medicaid prescription drugs.17b-274gPreferred drug list purchases. Prohibition on Medicaid cost sharing. Reporting, notice requirements for other Medicaid cost-sharing requirements.17b-274hAuto refills of prescription drugs covered under Medicaid. Limitations. Legislative review process.17b-275(Formerly Sec. 17-134r). Physician and pharmacy lock-in procedure.17b-276(Formerly Sec. 17-134s). Competitive bidding process for nonemergency transportation services. Disclosure of payment source. Fee schedules.17b-276aAmendment to Medicaid state plan to reduce expenditures for Medicaid nonemergency medical transportation. Limitations.17b-276bNonemergency medical transportation services. Prior authorization.17b-276cPayment for medically necessary mode of transportation service.17b-277(Formerly Sec. 17-134u). Medicaid for pregnant women. Presumptive Medicaid eligibility for pregnant women and newborn children. Postpartum care.17b-277aProgram to inform applicants to the Healthy Start program of services provided by the Connecticut Home Visiting System.17b-277bHealthy Start program. Plan. Review.17b-277cMedicaid coverage for donor breast milk. Requirements. Regulations.17b-277dMedicaid payment for maternity services. Regulations.17b-278(Formerly Sec. 17-134z). Home leave absences for certain medical assistance recipients.17b-278aCoverage for treatment for smoking cessation.17b-278bMedical assistance for breast and cervical cancer.17b-278cAmendment to state Medicaid plan to provide mammogram examinations to certain women.17b-278dAmendment to state Medicaid plan and state children's health insurance plan to provide neuropsychological testing for children diagnosed with cancer.17b-278eAmendment to state Medicaid plan to exclude payment for hospital-acquired conditions.17b-278fAmendment to state Medicaid plan to provide treatment for tuberculosis.17b-278gMedical assistance for eyeglasses and contact lenses. Regulations.17b-278hMedical assistance for chiropractic services. Regulations.17b-278iMedical assistance for customized wheelchairs. Definitions. Repairs. Refurbished equipment, parts and components. Regulations.17b-278jComplex rehabilitation technology. Definitions. Report.17b-278kElectronic transmission of prescriptions for durable medical equipment.17b-278lMedical assistance for obesity treatment, surgery. Definitions. State plan amendments.17b-278mMedicaid coverage of biomarker testing. Definitions. Requirements for coverage. Appeals.17b-278nMedicaid coverage of rapid whole genome sequencing for critically ill infants. Data use restrictions. Medical necessity criteria.17b-279(Formerly Sec. 17-134aa). Medicaid prescription drug utilization review. Erectile dysfunction drugs. Prior authorization requirement and coverage limitation. Report.17b-280(Formerly Sec. 17-134bb). Reimbursement rate for covered outpatient drugs under the Medicaid program.17b-280aPayment for over-the-counter medications under medical assistance program. Exceptions.17b-280bProposed revisions to reimbursement methodology for covered outpatient drugs under the Medicaid program. Legislative review.17b-280cMethadone maintenance. Minimum rates. Increase for providers receiving lowest weekly rates of reimbursement.17b-281(Formerly Sec. 17-134cc). Payment of oxygen products and services under medical assistance program.17b-281aProcedure for preauthorization of purchase or rental of durable medical equipment.17b-281bUsed durable medical equipment. Payments to vendors or suppliers.17b-281cAuthority of commissioner to modify medical equipment fee schedules.17b-282(Formerly Sec. 17-134dd). Medical assistance for certain children and elderly and disabled persons.17b-282aCoverage for in-patient dental services in certain instances involving children and developmentally disabled persons.17b-282bImplementation of state-wide dental plan. Waiver.17b-282cNonemergency dental services. Regulations.17b-282dCommissioner to modify nonemergency dental services. Regulations.17b-282eOrthodontic services for Medicaid recipients under twenty-one years of age.17b-282fMobile dental clinics. Medicaid coverage areas. Regulations.17b-283(Formerly Sec. 17-134ee). Medicaid home and community-based services waiver program for children and young adults with disabilities.17b-283aActive duty armed forces member application for Medicaid home or community-based program on behalf of eligible spouse or child.17b-284(Formerly Sec. 17-134ff). Medical assistance for certain employed persons.17b-285(Formerly Sec. 17-134gg). Assignment of spousal support of an institutionalized person or person in need of institutional care.17b-286Medicaid management information system. Reports.17b-287(Formerly Sec. 17-292a). Assistance for person who needs hospitalization and is not a resident of any town.17b-288Organ transplant account. Regulations.17b-289Short title: HUSKY and HUSKY Plus Act. HUSKY Plan, Part A and HUSKY Plan, Part B participants.17b-290Definitions.17b-291Children's health insurance plan.17b-292HUSKY B. Eligibility. Expedited eligibility under HUSKY B. Presumptive eligibility under Medicaid. State-funded coverage for certain children not otherwise covered. Postpartum care.17b-292aInformation for redetermination of eligibility under HUSKY Plan.17b-292bPrenatal care under HUSKY B. Unborn child option. Income eligibility.17b-293Minimum benefit coverage under HUSKY Plan, Part B.17b-294HUSKY Plus programs.17b-294aHUSKY Plus program. Administration. Eligibility. Regulations.17b-295Cost-sharing requirements under HUSKY B.17b-296Provision for clinicians in managed care plans. Provision by managed care organizations of services under HUSKY Plan.17b-297Outreach programs for HUSKY Plan, Part A and Part B.17b-297aFunds to promote enrollment of children eligible for other income-based assistance programs in HUSKY B.17b-297bProcedures for sharing information in applications for school lunch program for purpose of determining eligibility under HUSKY Health program.17b-298Regulations re quality of care under HUSKY Plan. Outcome criteria. Sanctions. Reports re HUSKY Plans to General Assembly.17b-299Applications. Approval.17b-300Notification of member's change of circumstance.17b-301Recovery of payment for false statement, misrepresentation or concealment.17b-301a to 17b-301pProhibited 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 withdrawal; manner of service; complaint under seal; intervening in action by Attorney General. Prosecution by Attorney General; withdrawal; settlement; limits on individual's participation; division of proceeds; attorneys' fees and costs. Civil action by individual when Attorney General declines to proceed; procedure; division of proceeds; attorneys' fees and costs. Attorney General's pursuit of claim through alternate remedy. Civil action by individual who committed prohibited act re medical assistance; reduction of proceeds; dismissal from action. Court's jurisdiction over civil actions brought by certain individuals. State not liable for expenses. Discrimination in employment because of acts in furtherance of civil action prohibited; remedies; attorneys' fees and costs. Time for bringing civil action; state's intervention in action. Standard of proof in civil action. Effect of final judgment in criminal proceeding on civil action. Remedies not exclusive. Report re medical assistance civil actions.17b-302Public involvement in design and implementation of HUSKY Plan, Part B. Submission of plan for public involvement to General Assembly.17b-303Income disregard. Application for federal waiver.17b-304Regulations.17b-30517b-30517b-306Plan for a system of preventive health services for children in the HUSKY Health program.17b-306aChild health quality improvement program. Purpose and scope. Annual reports.17b-307Primary care case management pilot program.17b-307aMedicaid reimbursement system incentivizing collaboration between primary care providers and behavioral and mental health care providers for HUSKY Health program members.17b-307bMedicaid reimbursement for suicide risk assessments and other mental health evaluations and services provided at school-based health centers or public schools.17b-308 to 17b-31017b-308 to 17b-31017b-311Charter Oak Health Plan.17b-312Medicaid waiver to seek federal funds to support the Covered Connecticut program.17b-313Innovation waiver for health care expansion.17b-314 to 17b-31917b-314 to 17b-319