2005 Connecticut Code - Sec. 17b-295. Cost-sharing requirements under HUSKY Plan, Part B.

      Sec. 17b-295. Cost-sharing requirements under HUSKY Plan, Part B. (a) The commissioner shall impose cost-sharing requirements including the payment of a premium or copayment in connection with services provided under the HUSKY Plan, Part B, to the extent permitted by federal law, and in accordance with the following limitations:

      (1) On and after October 1, 2003, the commissioner may increase the maximum annual aggregate cost-sharing requirements provided that such cost-sharing requirements shall not exceed five per cent of the family's gross annual income. The commissioner may impose a premium requirement on families, whose income exceeds one hundred eighty-five per cent of the federal poverty level as a component of the family's cost-sharing responsibility provided the family's annual combined premiums and copayments do not exceed the maximum annual aggregate cost-sharing requirement; and

      (2) The commissioner shall require each managed care plan to monitor copayments and premiums under the provisions of subdivision (1) of this subsection.

      (b) (1) Except as provided in subdivision (2) of this subsection, the commissioner may impose limitations on the amount, duration and scope of benefits under the HUSKY Plan, Part B.

      (2) The limitations adopted by the commissioner pursuant to subdivision (1) of this subsection shall not preclude coverage of any item of durable medical equipment or service that is medically necessary.

      (October 29 Sp. Sess. P.A. 97-1, S. 7, 23; P.A. 98-8, S. 2, 5; June 30 Sp. Sess. P.A. 03-3, S. 55.)

      History: Oct. 29 Sp. Sess. P.A. 97-1 effective October 30, 1997; P.A. 98-8 amended Subdiv. (3) of Subsec. (a) to require each managed care plan, rather than its health care providers, to monitor copayments and premiums, effective April 7, 1998; June 30 Sp. Sess. P.A. 03-3 amended Subsec. (a) to require commissioner to impose cost-sharing requirements in connection with services provided under the HUSKY Plan, Part B to the extent permitted by federal law, to delete "may require" re payment of premiums and copayments, to delete former Subdivs. (1) and (2) re maximum annual cost-sharing for families and add new Subdiv. (1) providing that on and after October 1, 2003, commissioner may increase maximum annual cost-sharing for families in an amount not to exceed five per cent of the family's gross annual income, and authorizing commissioner to impose a premium on families with income exceeding one hundred eighty-five per cent of the federal poverty level as a component of the family's cost-sharing responsibility provided family's combined premiums and copayments do not exceed the maximum annual cost-sharing requirement, and to redesignate former Subdiv. (3) redesignated as Subdiv. (2).