2019 Connecticut General Statutes
Title 17b - Social Services
Chapter 319v* - Medical Assistance

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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. 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.
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 homemaker-home health aide agencies. Appeals. Hearings. 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-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-251 - (Formerly Sec. 17a-307). Connecticut Partnership for Long-Term Care: Outreach program established.
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-256a to 17b-256c - Reserved for future use.
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-257 - (Formerly Sec. 17-12ii).
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-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-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 expenditures for children's health programs and services.
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.
Section 17b-277a - Program to inform applicants to the Healthy Start program of services provided by the Nurturing Families Network.
Section 17b-277b - Healthy Start program. Plan. Review.
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-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-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.
Section 17b-292a - Information for redetermination of eligibility under HUSKY Plan.
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 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.
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-305 - Reserved for future use.
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-308 to 17b-310 - Reserved for future use.
Section 17b-311 - Charter Oak Health Plan.
Section 17b-312 to 17b-319 - Reserved for future use.

*See Sec. 17b-259b re definition of “medically necessary” and “medical necessity” for purposes of medical assistance programs.

See Sec. 19a-45a re memorandum of understanding between Commissioners of Social Services and Public Health to improve delivery of public health services for low-income populations.

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2019 Connecticut General StatutesTitle 17b - Social ServicesChapter 319v* - Medical Assistance

2019 Connecticut General Statutes
Title 17b - Social Services
Chapter 319v* - Medical Assistance