| 1 | 1 | | General Assembly Governor's Bill No. 1013 |
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| 2 | 2 | | January Session, 2011 LCO No. 3600 |
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| 3 | 3 | | *03600__________* |
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| 4 | 4 | | Referred to Committee on Human Services |
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| 5 | 5 | | Introduced by: |
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| 6 | 6 | | SEN. WILLIAMS, 29th Dist. SEN. LOONEY, 11th Dist. REP. DONOVAN, 84th Dist. REP. SHARKEY, 88th Dist. |
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| 7 | 7 | | |
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| 8 | 8 | | General Assembly |
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| 9 | 9 | | |
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| 10 | 10 | | Governor's Bill No. 1013 |
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| 11 | 11 | | |
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| 12 | 12 | | January Session, 2011 |
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| 13 | 13 | | |
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| 14 | 14 | | LCO No. 3600 |
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| 15 | 15 | | |
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| 16 | 16 | | *03600__________* |
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| 17 | 17 | | |
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| 18 | 18 | | Referred to Committee on Human Services |
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| 19 | 19 | | |
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| 20 | 20 | | Introduced by: |
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| 21 | 21 | | |
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| 22 | 22 | | SEN. WILLIAMS, 29th Dist. |
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| 23 | 23 | | |
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| 24 | 24 | | SEN. LOONEY, 11th Dist. |
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| 25 | 25 | | |
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| 26 | 26 | | REP. DONOVAN, 84th Dist. |
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| 27 | 27 | | |
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| 28 | 28 | | REP. SHARKEY, 88th Dist. |
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| 29 | 29 | | |
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| 30 | 30 | | AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET RECOMMENDATIONS CONCERNING HUMAN SERVICES. |
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| 31 | 31 | | |
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| 32 | 32 | | Be it enacted by the Senate and House of Representatives in General Assembly convened: |
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| 33 | 33 | | |
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| 34 | 34 | | Section 1. Subdivision (4) of subsection (f) of section 17b-340 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 35 | 35 | | |
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| 36 | 36 | | (4) For the fiscal year ending June 30, 1992, (A) no facility shall receive a rate that is less than the rate it received for the rate year ending June 30, 1991; (B) no facility whose rate, if determined pursuant to this subsection, would exceed one hundred twenty per cent of the state-wide median rate, as determined pursuant to this subsection, shall receive a rate which is five and one-half per cent more than the rate it received for the rate year ending June 30, 1991; and (C) no facility whose rate, if determined pursuant to this subsection, would be less than one hundred twenty per cent of the state-wide median rate, as determined pursuant to this subsection, shall receive a rate which is six and one-half per cent more than the rate it received for the rate year ending June 30, 1991. For the fiscal year ending June 30, 1993, no facility shall receive a rate that is less than the rate it received for the rate year ending June 30, 1992, or six per cent more than the rate it received for the rate year ending June 30, 1992. For the fiscal year ending June 30, 1994, no facility shall receive a rate that is less than the rate it received for the rate year ending June 30, 1993, or six per cent more than the rate it received for the rate year ending June 30, 1993. For the fiscal year ending June 30, 1995, no facility shall receive a rate that is more than five per cent less than the rate it received for the rate year ending June 30, 1994, or six per cent more than the rate it received for the rate year ending June 30, 1994. For the fiscal years ending June 30, 1996, and June 30, 1997, no facility shall receive a rate that is more than three per cent more than the rate it received for the prior rate year. For the fiscal year ending June 30, 1998, a facility shall receive a rate increase that is not more than two per cent more than the rate that the facility received in the prior year. For the fiscal year ending June 30, 1999, a facility shall receive a rate increase that is not more than three per cent more than the rate that the facility received in the prior year and that is not less than one per cent more than the rate that the facility received in the prior year, exclusive of rate increases associated with a wage, benefit and staffing enhancement rate adjustment added for the period from April 1, 1999, to June 30, 1999, inclusive. For the fiscal year ending June 30, 2000, each facility, except a facility with an interim rate or replaced interim rate for the fiscal year ending June 30, 1999, and a facility having a certificate of need or other agreement specifying rate adjustments for the fiscal year ending June 30, 2000, shall receive a rate increase equal to one per cent applied to the rate the facility received for the fiscal year ending June 30, 1999, exclusive of the facility's wage, benefit and staffing enhancement rate adjustment. For the fiscal year ending June 30, 2000, no facility with an interim rate, replaced interim rate or scheduled rate adjustment specified in a certificate of need or other agreement for the fiscal year ending June 30, 2000, shall receive a rate increase that is more than one per cent more than the rate the facility received in the fiscal year ending June 30, 1999. For the fiscal year ending June 30, 2001, each facility, except a facility with an interim rate or replaced interim rate for the fiscal year ending June 30, 2000, and a facility having a certificate of need or other agreement specifying rate adjustments for the fiscal year ending June 30, 2001, shall receive a rate increase equal to two per cent applied to the rate the facility received for the fiscal year ending June 30, 2000, subject to verification of wage enhancement adjustments pursuant to subdivision (15) of this subsection. For the fiscal year ending June 30, 2001, no facility with an interim rate, replaced interim rate or scheduled rate adjustment specified in a certificate of need or other agreement for the fiscal year ending June 30, 2001, shall receive a rate increase that is more than two per cent more than the rate the facility received for the fiscal year ending June 30, 2000. For the fiscal year ending June 30, 2002, each facility shall receive a rate that is two and one-half per cent more than the rate the facility received in the prior fiscal year. For the fiscal year ending June 30, 2003, each facility shall receive a rate that is two per cent more than the rate the facility received in the prior fiscal year, except that such increase shall be effective January 1, 2003, and such facility rate in effect for the fiscal year ending June 30, 2002, shall be paid for services provided until December 31, 2002, except any facility that would have been issued a lower rate effective July 1, 2002, than for the fiscal year ending June 30, 2002, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2002, and have such rate increased two per cent effective June 1, 2003. For the fiscal year ending June 30, 2004, rates in effect for the period ending June 30, 2003, shall remain in effect, except any facility that would have been issued a lower rate effective July 1, 2003, than for the fiscal year ending June 30, 2003, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2003. For the fiscal year ending June 30, 2005, rates in effect for the period ending June 30, 2004, shall remain in effect until December 31, 2004, except any facility that would have been issued a lower rate effective July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2004. Effective January 1, 2005, each facility shall receive a rate that is one per cent greater than the rate in effect December 31, 2004. Effective upon receipt of all the necessary federal approvals to secure federal financial participation matching funds associated with the rate increase provided in this subdivision, but in no event earlier than July 1, 2005, and provided the user fee imposed under section 17b-320 is required to be collected, for the fiscal year ending June 30, 2006, the department shall compute the rate for each facility based upon its 2003 cost report filing or a subsequent cost year filing for facilities having an interim rate for the period ending June 30, 2005, as provided under section 17-311-55 of the regulations of Connecticut state agencies. For each facility not having an interim rate for the period ending June 30, 2005, the rate for the period ending June 30, 2006, shall be determined beginning with the higher of the computed rate based upon its 2003 cost report filing or the rate in effect for the period ending June 30, 2005. Such rate shall then be increased by eleven dollars and eighty cents per day except that in no event shall the rate for the period ending June 30, 2006, be thirty-two dollars more than the rate in effect for the period ending June 30, 2005, and for any facility with a rate below one hundred ninety-five dollars per day for the period ending June 30, 2005, such rate for the period ending June 30, 2006, shall not be greater than two hundred seventeen dollars and forty-three cents per day and for any facility with a rate equal to or greater than one hundred ninety-five dollars per day for the period ending June 30, 2005, such rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven and one-half per cent. For each facility with an interim rate for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven dollars and eighty cents per day plus the per day cost of the user fee payments made pursuant to section 17b-320 divided by annual resident service days, except for any facility with an interim rate below one hundred ninety-five dollars per day for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not be greater than two hundred seventeen dollars and forty-three cents per day and for any facility with an interim rate equal to or greater than one hundred ninety-five dollars per day for the period ending June 30, 2005, the interim replacement rate for the period ending June 30, 2006, shall not exceed the rate in effect for the period ending June 30, 2005, increased by eleven and one-half per cent. Such July 1, 2005, rate adjustments shall remain in effect unless (i) the federal financial participation matching funds associated with the rate increase are no longer available; or (ii) the user fee created pursuant to section 17b-320 is not in effect. For the fiscal year ending June 30, 2007, each facility shall receive a rate that is three per cent greater than the rate in effect for the period ending June 30, 2006, except any facility that would have been issued a lower rate effective July 1, 2006, than for the rate period ending June 30, 2006, due to interim rate status or agreement with the department, shall be issued such lower rate effective July 1, 2006. For the fiscal year ending June 30, 2008, each facility shall receive a rate that is two and nine-tenths per cent greater than the rate in effect for the period ending June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, than for the rate period ending June 30, 2007, due to interim rate status or agreement with the department, shall be issued such lower rate effective July 1, 2007. For the fiscal year ending June 30, 2009, rates in effect for the period ending June 30, 2008, shall remain in effect until June 30, 2009, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2009, due to interim rate status or agreement with the department shall be issued such lower rate. For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effect until June 30, 2011, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate. For the fiscal years ending June 30, 2012, and June 30, 2013, rates in effect for the period ending June 30, 2011, shall remain in effect until June 30, 2013, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, or the fiscal year ending June 30, 2013, due to interim rate status or agreement with the department, shall be issued such lower rate. The Commissioner of Social Services shall add fair rent increases to any other rate increases established pursuant to this subdivision for a facility which has undergone a material change in circumstances related to fair rent, except for the fiscal [year] years ending June 30, 2010, [and the fiscal year ending] June 30, 2011, June 30, 2012, and June 30, 2013, such fair rent increases shall only be provided to facilities with an approved certificate of need pursuant to section 17b-352, 17b-353, 17b-354 or 17b-355. Interim rates may take into account reasonable costs incurred by a facility, including wages and benefits. |
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| 37 | 37 | | |
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| 38 | 38 | | Sec. 2. Subsection (a) of section 17b-280 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 39 | 39 | | |
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| 40 | 40 | | (a) The state shall reimburse for all legend drugs provided under [the Medicaid, state-administered general assistance, ConnPACE and Connecticut AIDS drug assistance programs] medical assistance programs administered by the Department of Social Services at the [lower of (1) the rate established by the Centers for Medicare and Medicaid Services as the federal acquisition cost, (2) the average wholesale price minus fourteen per cent, or (3) an equivalent percentage as established under the Medicaid state plan] same rate negotiated by the state for outpatient prescription drugs dispensed to state employees in a retail setting. The [commissioner] state shall [also establish] pay a professional fee [of two dollars and ninety cents] to licensed pharmacies for each prescription [to be paid to licensed pharmacies for dispensing drugs to Medicaid, state-administered general assistance, ConnPACE and Connecticut AIDS drug assistance recipient] dispensed to a recipient of benefits under a medical assistance program administered by the Department of Social Services which shall be the same fee as that negotiated by the state for the dispensing of outpatient prescription drugs to state employees in a retail setting in accordance with federal regulations. [; and on] On and after September 4, 1991, payment for legend and nonlegend drugs provided to Medicaid recipients shall be based upon the actual package size dispensed. Effective October 1, 1991, reimbursement for over-the-counter drugs for such recipients shall be limited to those over-the-counter drugs and products published in the Connecticut Formulary, or the cross reference list, issued by the commissioner. The cost of all over-the-counter drugs and products provided to residents of nursing facilities, chronic disease hospitals, and intermediate care facilities for the mentally retarded shall be included in the facilities' per diem rate. Notwithstanding the provisions of this subsection, no dispensing fee shall be issued for a prescription drug dispensed to a ConnPACE or Medicaid recipient who is a Medicare Part D beneficiary when the prescription drug is a Medicare Part D drug, as defined in Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. |
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| 41 | 41 | | |
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| 42 | 42 | | Sec. 3. Subsection (b) of section 17b-104 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 43 | 43 | | |
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| 44 | 44 | | (b) On July 1, 2007, and annually thereafter, the commissioner shall increase the payment standards over those of the previous fiscal year under the temporary family assistance program and the state-administered general assistance program by the percentage increase, if any, in the most recent calendar year average in the consumer price index for urban consumers over the average for the previous calendar year, provided the annual increase, if any, shall not exceed five per cent, except that the payment standards for the fiscal years ending June 30, 2010, [and] June 30, 2011, June 30, 2012, and June 30, 2013, shall not be increased. |
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| 45 | 45 | | |
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| 46 | 46 | | Sec. 4. Subsection (a) of section 17b-106 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 47 | 47 | | |
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| 48 | 48 | | (a) [On January 1, 2006, and on each January first thereafter, the Commissioner of Social Services shall increase the unearned income disregard for recipients of the state supplement to the federal Supplemental Security Income Program by an amount equal to the federal cost-of-living adjustment, if any, provided to recipients of federal Supplemental Security Income Program benefits for the corresponding calendar year.] On July 1, 1989, and annually thereafter, the commissioner shall increase the adult payment standards over those of the previous fiscal year for the state supplement to the federal Supplemental Security Income Program by the percentage increase, if any, in the most recent calendar year average in the consumer price index for urban consumers over the average for the previous calendar year, provided the annual increase, if any, shall not exceed five per cent, except that the adult payment standards for the fiscal years ending June 30, 1993, June 30, 1994, June 30, 1995, June 30, 1996, June 30, 1997, June 30, 1998, June 30, 1999, June 30, 2000, June 30, 2001, June 30, 2002, June 30, 2003, June 30, 2004, June 30, 2005, June 30, 2006, June 30, 2007, June 30, 2008, June 30, 2009, June 30, 2010, [and] June 30, 2011, June 30, 2012, and June 30, 2013, shall not be increased. Effective October 1, 1991, the coverage of excess utility costs for recipients of the state supplement to the federal Supplemental Security Income Program is eliminated. Notwithstanding the provisions of this section, the commissioner may increase the personal needs allowance component of the adult payment standard as necessary to meet federal maintenance of effort requirements. |
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| 49 | 49 | | |
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| 50 | 50 | | Sec. 5. Section 17b-311 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 51 | 51 | | |
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| 52 | 52 | | (a) There is established the Charter Oak Health Plan for the purpose of providing access to health insurance coverage for state residents who have been uninsured for at least six months, [and] who are ineligible for other publicly funded health insurance plans and who are ineligible for the high-risk pool established pursuant to Section 1101 of the Patient Protection and Affordable Care Act, P.L. 111-148. The Commissioner of Social Services may enter into contracts for the provision of comprehensive health care for such uninsured state residents. The commissioner shall conduct outreach to facilitate enrollment in the plan. |
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| 53 | 53 | | |
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| 54 | 54 | | (b) The commissioner shall impose cost-sharing requirements in connection with services provided under the Charter Oak Health Plan. Such requirements may include, but not be limited to: (1) A monthly premium; (2) an annual deductible not to exceed one thousand dollars; (3) a coinsurance payment not to exceed twenty per cent after the deductible amount is met; (4) tiered copayments for prescription drugs determined by whether the drug is generic or brand name, formulary or nonformulary and whether purchased through mail order; (5) no fee for emergency visits to hospital emergency rooms; (6) a copayment not to exceed one hundred fifty dollars for nonemergency visits to hospital emergency rooms; and (7) a lifetime benefit not to exceed one million dollars. |
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| 55 | 55 | | |
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| 56 | 56 | | (c) (1) The Commissioner of Social Services shall provide premium assistance to eligible state residents whose gross annual income does not exceed three hundred per cent of the federal poverty level. Such premium assistance shall be limited to: (A) One hundred [seventy-five] fifteen dollars per month for individuals whose gross annual income is below one hundred fifty per cent of the federal poverty level; (B) one hundred [fifty] dollars per month for individuals whose gross annual income is at or above one hundred fifty per cent of the federal poverty level but not more than one hundred eighty-five per cent of the federal poverty level; (C) [seventy-five] fifty dollars per month for individuals whose gross annual income is above one hundred eighty-five per cent of the federal poverty level but not more than two hundred thirty-five per cent of the federal poverty level; and (D) [fifty] thirty-five dollars per month for individuals whose gross annual income is above two hundred thirty-five per cent of the federal poverty level but not more than three hundred per cent of the federal poverty level. Individuals insured under the Charter Oak Health Plan shall pay their share of payment for coverage in the plan directly to the insurer. |
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| 57 | 57 | | |
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| 58 | 58 | | (2) Notwithstanding the provisions of this subsection, for the fiscal years ending June 30, 2010, [and] June 30, 2011, and each fiscal year thereafter, the Commissioner of Social Services shall only provide premium assistance to state residents who are eligible for such assistance and who are enrolled in the Charter Oak Health Plan on [April 30, 2010] May 31, 2010. |
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| 59 | 59 | | |
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| 60 | 60 | | (d) The Commissioner of Social Services shall determine minimum requirements on the amount, duration and scope of benefits under the Charter Oak Health Plan, except that there shall be no preexisting condition exclusion. Each participating insurer or administrative services organization shall provide an internal grievance process by which an enrollee in the Charter Oak Health Plan may request and be provided a review of a denial of coverage under the plan. |
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| 61 | 61 | | |
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| 62 | 62 | | (e) The Commissioner of Social Services shall seek proposals from entities described in subsection (e) of this section based on the cost sharing and benefits described in subsections (b) and (c) of this section. The commissioner may approve an alternative plan in order to make coverage options available to those eligible to be insured under the plan. |
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| 63 | 63 | | |
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| 64 | 64 | | (f) The Commissioner of Social Services, pursuant to section 17b-10, may implement policies and procedures to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the commissioner prints notice of the intent to adopt the regulation in the Connecticut Law Journal not later than twenty days after the date of implementation. Such policies shall be valid until the time final regulations are adopted and may include: (1) Exceptions to the requirement that a resident be uninsured for at least six months to be eligible for the Charter Oak Health Plan; and (2) requirements for open enrollment and limitations on the ability of enrollees to change plans between such open enrollment periods. |
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| 65 | 65 | | |
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| 66 | 66 | | Sec. 6. (NEW) (Effective July 1, 2011) The Commissioner of Social Services shall limit the extent of adult dental services provided under the Medicaid program to such services that may be provided within available appropriations. The commissioner may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided the commissioner prints notice of intent to adopt regulations in the Connecticut Law Journal not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted. |
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| 67 | 67 | | |
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| 68 | 68 | | Sec. 7. (NEW) (Effective July 1, 2011) The Commissioner of Social Services shall, to the extent permitted by federal law, impose cost-sharing requirements on Medicaid recipients, except copayments shall not be imposed for the following services: (1) Inpatient hospitalization; (2) hospital emergency; (3) home health care; (4) those provided pursuant to a home and community-based services waiver; (5) laboratory; (6) emergency ambulance; and (7) nonemergency medical transportation. The aggregate cost-sharing requirements for prescription drugs shall not exceed twenty dollars per month. |
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| 69 | 69 | | |
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| 70 | 70 | | Sec. 8. Subsection (a) of section 17b-244 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 71 | 71 | | |
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| 72 | 72 | | (a) The room and board component of the rates to be paid by the state to private facilities and facilities operated by regional education service centers which are licensed to provide residential care pursuant to section 17a-227, but not certified to participate in the Title XIX Medicaid program as intermediate care facilities for persons with mental retardation, shall be determined annually by the Commissioner of Social Services, except that rates effective April 30, 1989, shall remain in effect through October 31, 1989. Any facility with real property other than land placed in service prior to July 1, 1991, shall, for the fiscal year ending June 30, 1995, receive a rate of return on real property equal to the average of the rates of return applied to real property other than land placed in service for the five years preceding July 1, 1993. For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the rate of return on real property for property items shall be revised every five years. The commissioner shall, upon submission of a request by such facility, allow actual debt service, comprised of principal and interest, on the loan or loans in lieu of property costs allowed pursuant to section 17-313b-5 of the regulations of Connecticut state agencies, whether actual debt service is higher or lower than such allowed property costs, provided such debt service terms and amounts are reasonable in relation to the useful life and the base value of the property. In the case of facilities financed through the Connecticut Housing Finance Authority, the commissioner shall allow actual debt service, comprised of principal, interest and a reasonable repair and replacement reserve on the loan or loans in lieu of property costs allowed pursuant to section 17-313b-5 of the regulations of Connecticut state agencies, whether actual debt service is higher or lower than such allowed property costs, provided such debt service terms and amounts are determined by the commissioner at the time the loan is entered into to be reasonable in relation to the useful life and base value of the property. The commissioner may allow fees associated with mortgage refinancing provided such refinancing will result in state reimbursement savings, after comparing costs over the terms of the existing proposed loans. For the fiscal year ending June 30, 1992, the inflation factor used to determine rates shall be one-half of the gross national product percentage increase for the period between the midpoint of the cost year through the midpoint of the rate year. For fiscal year ending June 30, 1993, the inflation factor used to determine rates shall be two-thirds of the gross national product percentage increase from the midpoint of the cost year to the midpoint of the rate year. For the fiscal years ending June 30, 1996, and June 30, 1997, no inflation factor shall be applied in determining rates. The Commissioner of Social Services shall prescribe uniform forms on which such facilities shall report their costs. Such rates shall be determined on the basis of a reasonable payment for necessary services. Any increase in grants, gifts, fund-raising or endowment income used for the payment of operating costs by a private facility in the fiscal year ending June 30, 1992, shall be excluded by the commissioner from the income of the facility in determining the rates to be paid to the facility for the fiscal year ending June 30, 1993, provided any operating costs funded by such increase shall not obligate the state to increase expenditures in subsequent fiscal years. Nothing contained in this section shall authorize a payment by the state to any such facility in excess of the charges made by the facility for comparable services to the general public. The service component of the rates to be paid by the state to private facilities and facilities operated by regional education service centers which are licensed to provide residential care pursuant to section 17a-227, but not certified to participate in the Title XIX Medicaid programs as intermediate care facilities for persons with mental retardation, shall be determined annually by the Commissioner of Developmental Services in accordance with section 17b-244a. For the fiscal year ending June 30, 2008, no facility shall receive a rate that is more than two per cent greater than the rate in effect for the facility on June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, due to interim rate status or agreement with the department, shall be issued such lower rate effective July 1, 2007. For the fiscal year ending June 30, 2009, no facility shall receive a rate that is more than two per cent greater than the rate in effect for the facility on June 30, 2008, except any facility that would have been issued a lower rate effective July 1, 2008, due to interim rate status or agreement with the department, shall be issued such lower rate effective July 1, 2008. For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effect until June 30, 2011, except that (1) the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2009, if a capital improvement required by the Commissioner of Developmental Services for the health or safety of the residents was made to the facility during the fiscal years ending June 30, 2010, or June 30, 2011, and (2) any facility that would have been issued a lower rate for the fiscal years ending June 30, 2010, or June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate. For the fiscal years ending June 30, 2012, and June 30, 2013, rates in effect for the period ending June 30, 2011, shall remain in effect until June 30, 2013, except that (1) the rate paid to a facility may be higher than the rate paid to the facility for the period ending June 30, 2011, if a capital improvement required by the Commissioner of Developmental Services for the health or safety of the residents was made to the facility during the fiscal years ending June 30, 2012, or June 30, 2013, and (2) any facility that would have been issued a lower rate for the fiscal years ending June 30, 2012, or June 30, 2013, due to interim rate status or agreement with the department, shall be issued such lower rate. |
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| 73 | 73 | | |
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| 74 | 74 | | Sec. 9. Subdivision (1) of subsection (h) of section 17b-340 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 75 | 75 | | |
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| 76 | 76 | | (h) (1) For the fiscal year ending June 30, 1993, any residential care home with an operating cost component of its rate in excess of one hundred thirty per cent of the median of operating cost components of rates in effect January 1, 1992, shall not receive an operating cost component increase. For the fiscal year ending June 30, 1993, any residential care home with an operating cost component of its rate that is less than one hundred thirty per cent of the median of operating cost components of rates in effect January 1, 1992, shall have an allowance for real wage growth equal to sixty-five per cent of the increase determined in accordance with subsection (q) of section 17-311-52 of the regulations of Connecticut state agencies, provided such operating cost component shall not exceed one hundred thirty per cent of the median of operating cost components in effect January 1, 1992. Beginning with the fiscal year ending June 30, 1993, for the purpose of determining allowable fair rent, a residential care home with allowable fair rent less than the twenty-fifth percentile of the state-wide allowable fair rent shall be reimbursed as having allowable fair rent equal to the twenty-fifth percentile of the state-wide allowable fair rent. Beginning with the fiscal year ending June 30, 1997, a residential care home with allowable fair rent less than three dollars and ten cents per day shall be reimbursed as having allowable fair rent equal to three dollars and ten cents per day. Property additions placed in service during the cost year ending September 30, 1996, or any succeeding cost year shall receive a fair rent allowance for such additions as an addition to three dollars and ten cents per day if the fair rent for the facility for property placed in service prior to September 30, 1995, is less than or equal to three dollars and ten cents per day. For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the allowance for real wage growth, as determined in accordance with subsection (q) of section 17-311-52 of the regulations of Connecticut state agencies, shall not be applied. For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the inflation adjustment made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies shall not be applied to real property costs. Beginning with the fiscal year ending June 30, 1997, minimum allowable patient days for rate computation purposes for a residential care home with twenty-five beds or less shall be eighty-five per cent of licensed capacity. Beginning with the fiscal year ending June 30, 2002, for the purposes of determining the allowable salary of an administrator of a residential care home with sixty beds or less the department shall revise the allowable base salary to thirty-seven thousand dollars to be annually inflated thereafter in accordance with section 17-311-52 of the regulations of Connecticut state agencies. The rates for the fiscal year ending June 30, 2002, shall be based upon the increased allowable salary of an administrator, regardless of whether such amount was expended in the 2000 cost report period upon which the rates are based. Beginning with the fiscal year ending June 30, 2000, the inflation adjustment for rates made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies shall be increased by two per cent, and beginning with the fiscal year ending June 30, 2002, the inflation adjustment for rates made in accordance with subsection (c) of said section shall be increased by one per cent. Beginning with the fiscal year ending June 30, 1999, for the purpose of determining the allowable salary of a related party, the department shall revise the maximum salary to twenty-seven thousand eight hundred fifty-six dollars to be annually inflated thereafter in accordance with section 17-311-52 of the regulations of Connecticut state agencies and beginning with the fiscal year ending June 30, 2001, such allowable salary shall be computed on an hourly basis and the maximum number of hours allowed for a related party other than the proprietor shall be increased from forty hours to forty-eight hours per work week. For the fiscal year ending June 30, 2005, each facility shall receive a rate that is two and one-quarter per cent more than the rate the facility received in the prior fiscal year, except any facility that would have been issued a lower rate effective July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2004. Effective upon receipt of all the necessary federal approvals to secure federal financial participation matching funds associated with the rate increase provided in subdivision (4) of subsection (f) of this section, but in no event earlier than October 1, 2005, and provided the user fee imposed under section 17b-320 is required to be collected, each facility shall receive a rate that is determined in accordance with applicable law and subject to appropriations, except any facility that would have been issued a lower rate effective October 1, 2005, than for the fiscal year ending June 30, 2005, due to interim rate status or agreement with the department, shall be issued such lower rate effective October 1, 2005. Such rate increase shall remain in effect unless: (A) The federal financial participation matching funds associated with the rate increase are no longer available; or (B) the user fee created pursuant to section 17b-320 is not in effect. For the fiscal year ending June 30, 2007, rates in effect for the period ending June 30, 2006, shall remain in effect until September 30, 2006, except any facility that would have been issued a lower rate effective July 1, 2006, than for the fiscal year ending June 30, 2006, due to interim rate status or agreement with the department, shall be issued such lower rate effective July 1, 2006. Effective October 1, 2006, no facility shall receive a rate that is more than four per cent greater than the rate in effect for the facility on September 30, 2006, except for any facility that would have been issued a lower rate effective October 1, 2006, due to interim rate status or agreement with the department, shall be issued such lower rate effective October 1, 2006. For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effect until June 30, 2011, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate, except (i) any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the Commissioner of Social Services shall be issued such lower rate; and (ii) the commissioner may increase a facility's rate for reasonable costs associated with such facility's compliance with the provisions of section 19a-495a, as amended by this act, concerning the administration of medication by unlicensed personnel. For the fiscal years ending June 30, 2012, and June 30, 2013, rates in effect for the period ending June 30, 2011, shall remain in effect until June 30, 2013, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, or the fiscal year ending June 30, 2013, due to interim rate status or agreement with the department, shall be issued such lower rate, except (I) any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, or the fiscal year ending June 30, 2013, due to interim rate status or agreement with the Commissioner of Social Services shall be issued such lower rate; and (II) the commissioner may increase a facility's rate for reasonable costs associated with such facility's compliance with the provisions of section 19a-495a, as amended by this act, concerning the administration of medication by unlicensed personnel. |
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| 77 | 77 | | |
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| 78 | 78 | | Sec. 10. (NEW) (Effective July 1, 2011) (a) The Commissioner of Social Services shall only authorize payment for the mode of transportation service that is medically necessary for a recipient of assistance under a medical assistance program administered by the Department of Social Services. Notwithstanding any provisions of the general statutes or regulations of Connecticut state agencies, a recipient who requires nonemergency transportation and who must be transported in a prone position but who does not require medical services during transport may be transported in a stretcher van. The commissioner shall establish rates for nonemergency transportation provided by stretcher van. |
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| 79 | 79 | | |
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| 80 | 80 | | (b) Notwithstanding any provision of the general statutes or the regulations of Connecticut state agencies, the Commissioner of Transportation shall adopt regulations, in accordance with chapter 54 of the general statutes, to establish oversight of stretcher vans as a livery service for which a permit is required, provided certification issued by the Department of Public Health to provide transportation on a stretcher shall be sufficient qualification to be issued a stretcher van permit by the Commissioner of Transportation. |
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| 81 | 81 | | |
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| 82 | 82 | | Sec. 11. Subsection (a) of section 19a-180 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 83 | 83 | | |
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| 84 | 84 | | (a) No person shall operate any ambulance service, rescue service or management service [or otherwise transport in a motor vehicle a patient on a stretcher] without either a license or a certificate issued by the commissioner. No person shall operate a commercial ambulance service or commercial rescue service or a management service without a license issued by the commissioner. A certificate shall be issued to any volunteer or municipal ambulance service which shows proof satisfactory to the commissioner that it meets the minimum standards of the commissioner in the areas of training, equipment and personnel. No license or certificate shall be issued to any volunteer, municipal or commercial ambulance service, rescue service or management service, as defined in subdivision (19) of section 19a-175, as amended by this act, unless it meets the requirements of subsection (e) of section 14-100a. Applicants for a license shall use the forms prescribed by the commissioner and shall submit such application to the commissioner accompanied by an annual fee of two hundred dollars. In considering requests for approval of permits for new or expanded emergency medical services in any region, the commissioner shall consult with the Office of Emergency Medical Services and the emergency medical services council of such region and shall hold a public hearing to determine the necessity for such services. Written notice of such hearing shall be given to current providers in the geographic region where such new or expanded services would be implemented, provided, any volunteer ambulance service which elects not to levy charges for services rendered under this chapter shall be exempt from the provisions concerning requests for approval of permits for new or expanded emergency medical services set forth in this subsection. A primary service area responder that operates in the service area identified in the application shall, upon request, be granted intervenor status with opportunity for cross-examination. Each applicant for licensure shall furnish proof of financial responsibility which the commissioner deems sufficient to satisfy any claim. The commissioner may adopt regulations, in accordance with the provisions of chapter 54, to establish satisfactory kinds of coverage and limits of insurance for each applicant for either licensure or certification. Until such regulations are adopted, the following shall be the required limits for licensure: (1) For damages by reason of personal injury to, or the death of, one person on account of any accident, at least five hundred thousand dollars, and more than one person on account of any accident, at least one million dollars, (2) for damage to property at least fifty thousand dollars, and (3) for malpractice in the care of one passenger at least two hundred fifty thousand dollars, and for more than one passenger at least five hundred thousand dollars. In lieu of the limits set forth in subdivisions (1) to (3), inclusive, of this subsection, a single limit of liability shall be allowed as follows: (A) For damages by reason of personal injury to, or death of, one or more persons and damage to property, at least one million dollars; and (B) for malpractice in the care of one or more passengers, at least five hundred thousand dollars. A certificate of such proof shall be filed with the commissioner. Upon determination by the commissioner that an applicant is financially responsible, properly certified and otherwise qualified to operate a commercial ambulance service, rescue service or management service, the commissioner shall issue the appropriate license effective for one year to such applicant. If the commissioner determines that an applicant for either a certificate or license is not so qualified, the commissioner shall notify such applicant of the denial of the application with a statement of the reasons for such denial. Such applicant shall have thirty days to request a hearing on the denial of the application. |
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| 85 | 85 | | |
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| 86 | 86 | | Sec. 12. Subdivision (11) of section 19a-175 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 87 | 87 | | |
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| 88 | 88 | | (11) "Invalid coach" means a vehicle used exclusively for the transportation of nonambulatory patients [, who are not confined to stretchers,] to or from either a medical facility or the patient's home in nonemergency situations or utilized in emergency situations as a backup vehicle when insufficient emergency vehicles exist; |
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| 89 | 89 | | |
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| 90 | 90 | | Sec. 13. Section 17b-28e of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 91 | 91 | | |
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| 92 | 92 | | (a) The Commissioner of Social Services shall amend the Medicaid state plan to include, on and after January 1, 2009, hospice services as optional services covered under the Medicaid program. Said state plan amendment shall supersede any regulations of Connecticut state agencies concerning such optional services. |
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| 93 | 93 | | |
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| 94 | 94 | | (b) [Not later than February 1, 2011] Effective July 1, 2013, the Commissioner of Social Services shall [amend the Medicaid state plan to include] enter into a contract to provide foreign language interpreter services [provided] to any beneficiary with limited English proficiency [as a covered service] under the Medicaid program. [Not later than February 1, 2011, the commissioner shall develop and implement the use of medical billing codes for foreign language interpreter services for the HUSKY Plan, Part A and Part B, and for the fee-for-services Medicaid programs.] |
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| 95 | 95 | | |
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| 96 | 96 | | [(c) Each care management organization that enters into a contract with the Department of Social Services to provide foreign language interpreter services under the HUSKY Plan, Part A shall report, semi-annually, to the department on the interpreter services provided to recipients of benefits under the program. Such written reports shall be submitted to the department not later than June first and December thirty-first each year. Not later than thirty days after receipt of such report, the department shall submit a copy of the report, in accordance with the provisions of section 11-4a, to the Council on Medicaid Care Management Oversight.] |
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| 97 | 97 | | |
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| 98 | 98 | | Sec. 14. Subdivisions (1) and (2) of subsection (i) of section 17b-342 of the general statutes are repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 99 | 99 | | |
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| 100 | 100 | | (i) (1) On and after July 1, 1992, the Commissioner of Social Services shall, within available appropriations, administer a state-funded portion of the program for persons (A) who are sixty-five years of age and older; (B) who are inappropriately institutionalized or at risk of inappropriate institutionalization; (C) whose income is less than or equal to the amount allowed under subdivision (3) of subsection (a) of this section; and (D) whose assets, if single, do not exceed the minimum community spouse protected amount pursuant to Section 4022.05 of the department's uniform policy manual or, if married, the couple's assets do not exceed one hundred fifty per cent of said community spouse protected amount and on and after April 1, 2007, whose assets, if single, do not exceed one hundred fifty per cent of the minimum community spouse protected amount pursuant to Section 4022.05 of the department's uniform policy manual or, if married, the couple's assets do not exceed two hundred per cent of said community spouse protected amount. Notwithstanding any provision of this section, for program applications received by the Department of Social Services on or after July 1, 2011, only persons who require the level of care provided in a nursing home shall be eligible for the state-funded portion of the program. |
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| 101 | 101 | | |
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| 102 | 102 | | (2) Except for persons residing in affordable housing under the assisted living demonstration project established pursuant to section 17b-347e, as provided in subdivision (3) of this subsection, any person whose income is at or below two hundred per cent of the federal poverty level and who is ineligible for Medicaid shall contribute [six] fifteen per cent of the cost of his or her care. Any person whose income exceeds two hundred per cent of the federal poverty level shall contribute [six] fifteen per cent of the cost of his or her care in addition to the amount of applied income determined in accordance with the methodology established by the Department of Social Services for recipients of medical assistance. Any person who does not contribute to the cost of care in accordance with this subdivision, shall be ineligible to receive services under this subsection. Notwithstanding any provision of the general statutes, the department shall not be required to provide an administrative hearing to a person found ineligible for services under this subsection because of a failure to contribute to the cost of care. |
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| 103 | 103 | | |
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| 104 | 104 | | Sec. 15. Section 19a-495a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 105 | 105 | | |
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| 106 | 106 | | (a) (1) The Commissioner of Public Health shall adopt regulations, as provided in subsection (d) of this section, to require each residential care home, as defined in section 19a-490, as amended by this act, that admits residents requiring assistance with medication administration, and each home health care agency, as defined in section 19a-490, as amended by this act, that serves clients requiring assistance with medication administration to (A) designate unlicensed personnel to obtain certification for the administration of medication, and (B) to ensure that such unlicensed personnel receive such certification. |
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| 107 | 107 | | |
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| 108 | 108 | | (2) The regulations shall establish criteria to be used by such homes and agencies in determining (A) the appropriate number of unlicensed personnel who shall obtain such certification, and (B) training requirements, including on-going training requirements for such certification. Training requirements shall include, but shall not be limited to: Initial orientation, resident rights, identification of the types of medication that may be administered by unlicensed personnel, behavioral management, personal care, nutrition and food safety, and health and safety in general. |
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| 109 | 109 | | |
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| 110 | 110 | | (b) Each residential care home, as defined in section 19a-490, as amended by this act, shall ensure that, on or before January 1, 2010, an appropriate number of unlicensed personnel, as determined by the residential care home, obtain certification for the administration of medication. Each home health care agency, as defined in section 19a-490, as amended by this act, shall ensure that, on or before January 1, 2012, an appropriate number of unlicensed personnel, as determined by the home health care agency, obtain certification for the administration of medication. Certification of such personnel shall be in accordance with regulations adopted pursuant to this section. Unlicensed personnel obtaining such certification may administer medications that are not administered by injection to residents of such homes or clients of such home health care agencies, unless a resident's physician specifies that a medication only be administered by licensed personnel. |
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| 111 | 111 | | |
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| 112 | 112 | | (c) On and after October 1, 2007, unlicensed assistive personnel employed in residential care homes, as defined in section 19a-490, may (1) obtain and document residents' blood pressures and temperatures with digital medical instruments that (A) contain internal decision-making electronics, microcomputers or special software that allow the instruments to interpret physiologic signals, and (B) do not require the user to employ any discretion or judgment in their use; (2) obtain and document residents' weight; and (3) assist residents in the use of glucose monitors to obtain and document their blood glucose levels. |
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| 113 | 113 | | |
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| 114 | 114 | | (d) The Commissioner of Public Health may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the commissioner prints notice of intent to adopt regulations in the Connecticut Law Journal not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted. |
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| 115 | 115 | | |
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| 116 | 116 | | Sec. 16. Section 17b-490 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 117 | 117 | | |
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| 118 | 118 | | As used in sections 17b-490 to 17b-498, inclusive, as amended by this act: |
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| 119 | 119 | | |
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| 120 | 120 | | (a) "Pharmacy" means a pharmacy licensed under section 20-594 or a pharmacy located in a health care institution, as defined in subsection (a) of section 19a-490, as amended by this act, which elects to participate in the program; |
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| 121 | 121 | | |
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| 122 | 122 | | (b) "Prescription drugs" means (1) legend drugs, as defined in section 20-571, (2) any other drugs which by state law or regulation require the prescription of a licensed practitioner for dispensing, except: (A) Products prescribed for cosmetic purposes as specified in regulations adopted pursuant to section 17b-494; (B) on and after September 15, 1991, diet pills, smoking cessation gum, contraceptives, multivitamin combinations, cough preparations and antihistamines; (C) drugs for the treatment of erectile dysfunction, unless such drug is prescribed to treat a condition other than sexual or erectile dysfunction, for which the drug has been approved by the Food and Drug Administration; and (D) drugs for the treatment of erectile dysfunction for persons who have been convicted of a sexual offense who are required to register with the Commissioner of Public Safety pursuant to chapter 969, and (3) insulin and insulin syringes; |
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| 123 | 123 | | |
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| 124 | 124 | | (c) "Reasonable cost" means the cost of the prescription drug determined in accordance with the formula adopted by the Commissioner of Social Services in regulations for medical assistance purposes plus a dispensing fee equal to the fee determined by said commissioner for medical assistance purposes; |
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| 125 | 125 | | |
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| 126 | 126 | | (d) "Resident" means a person legally domiciled within the state for a period of not less than one hundred eighty-three days immediately preceding the date of application for inclusion in the program. Mere seasonal or temporary residences within the state, of whatever duration, shall not constitute domicile; |
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| 127 | 127 | | |
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| 128 | 128 | | (e) "Disabled" means a person over eighteen years of age who is receiving disability payments pursuant to either Title 2 or Title 16 of the Social Security Act of 1935, as amended; |
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| 129 | 129 | | |
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| 130 | 130 | | (f) "Commissioner" means the Commissioner of Social Services; |
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| 131 | 131 | | |
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| 132 | 132 | | (g) "Income" means adjusted gross income as determined for purposes of the federal income tax plus any other income of such person not included in such adjusted gross income. [minus Medicare Part B premium payments.] The amount of any Medicaid payments made on behalf of such person or the spouse of such person shall not constitute income; |
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| 133 | 133 | | |
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| 134 | 134 | | (h) "Program" means the Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled Program otherwise known as ConnPACE; |
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| 135 | 135 | | |
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| 136 | 136 | | (i) "Pharmaceutical manufacturer" means any entity holding legal title to or possession of a national drug code number issued by the federal Food and Drug Administration; |
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| 137 | 137 | | |
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| 138 | 138 | | (j) "Average manufacturer price" means the average price paid by a wholesaler to a pharmaceutical manufacturer, after the deduction of any customary prompt payment discounts, for a product distributed for retail sale. [;] |
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| 139 | 139 | | |
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| 140 | 140 | | [(k) "Assets" means a person's resources, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003; |
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| 141 | 141 | | |
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| 142 | 142 | | (l) "Low income subsidy" means a premium and cost-sharing subsidy for low-income individuals, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003; |
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| 143 | 143 | | |
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| 144 | 144 | | (m) "Medicare Part D covered prescription drugs" means drugs that are included in Medicare Part D plan's formulary or are treated as being included in a Medicare Part D plan's formulary, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement and Modernization Act of 2003; |
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| 145 | 145 | | |
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| 146 | 146 | | (n) "Medicare Part D plan" means a Medicare Part D plan, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003; |
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| 147 | 147 | | |
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| 148 | 148 | | (o) "Gap in standard Medicare Part D coverage" means a drug obtained after a Medicare Part D beneficiary's initial coverage limit has been exceeded but before the beneficiary's annual out-of-pocket threshold has been met, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.] |
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| 149 | 149 | | |
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| 150 | 150 | | Sec. 17. Section 17b-492 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 151 | 151 | | |
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| 152 | 152 | | (a) Eligibility for participation in the program shall be limited to any resident (1) who is sixty-five years of age or older or who is disabled, (2) whose current annual income at the time of application or redetermination, if unmarried, is less than twenty thousand eight hundred dollars or whose annual income, if married, when combined with that of the resident's spouse is less than twenty-eight thousand one hundred dollars, (3) who is not eligible for Medicare or insured under a policy which provides full or partial coverage for prescription drugs once a deductible is met, [except for a Medicare prescription drug discount card endorsed by the Secretary of Health and Human Services in accordance with Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, or coverage under Medicare Part D pursuant to said act, and] (4) on and after September 15, 1991, who pays an annual forty-five-dollar registration fee to the Department of Social Services, and (5) who is enrolled in the program on or before June 30, 2011. On January 1, 2012, and annually thereafter, the commissioner shall increase the income limits established under this subsection over those of the previous fiscal year to reflect the annual inflation adjustment in Social Security income, if any. Each such adjustment shall be determined to the nearest one hundred dollars. On and after October 1, 2009, new applications to participate in the ConnPACE program may be accepted only from the fifteenth day of November through the thirty-first day of December each year, except that individuals may apply within thirty-one days of (A) reaching sixty-five years of age, or (B) becoming eligible for Social Security Disability Income or Supplemental Security Income. |
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| 153 | 153 | | |
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| 154 | 154 | | (b) (1) Payment for a prescription under the program shall be made only if no other plan of insurance or assistance is available to an eligible person for such prescription at the time of dispensing. [, except for benefits received from an endorsed Medicare prescription drug discount card or benefits provided under Medicare Part D.] The pharmacy shall make reasonable efforts to ascertain the existence of other insurance or assistance. [, including the subsidy provided by an endorsed Medicare prescription drug discount card or benefits provided under Medicare Part D. A Medicare prescription drug discount card beneficiary shall be responsible for the payment of any Medicare prescription drug discount card coinsurance requirements, provided such requirements do not exceed the ConnPACE program copayment requirements. If a Medicare prescription drug discount card beneficiary's coinsurance requirements exceed the ConnPACE copayment requirements, the Department of Social Services shall make payment to the pharmacy to cover costs in excess of the ConnPACE copayment amount. If the cost to such beneficiary exceeds the remaining available Medicare prescription drug discount card subsidy, the beneficiary shall not be responsible for any payment in excess of the amount of the ConnPACE program copayment requirement. In such cases, the Department of Social Services shall make payment to the pharmacy to cover costs in excess of the ConnPACE copayment amount.] |
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| 155 | 155 | | |
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| 156 | 156 | | [(2) A Medicare Part D beneficiary shall be responsible for the payment of Medicare Part D copayments, coinsurance and deductible requirements for Medicare-Part-D-covered prescription drugs, as defined in Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, to the extent such requirements do not exceed the ConnPACE program copayment requirements. The Department of Social Services shall pay Medicare Part D monthly beneficiary premiums on behalf of the beneficiary. If a Medicare Part D beneficiary's out-of-pocket copayment, coinsurance or deductible requirements exceed the ConnPACE copayment requirements, the department shall make payment to the pharmacy to cover costs in excess of the ConnPACE copayment amount. The department shall be responsible for payment of a Medicare-Part-D-covered prescription drug obtained during the gap in standard Medicare Part D coverage. To the extent permitted under said act, such payment may be made by the department for a prescription at (A) the lower of the price that would be paid under the ConnPACE program or the negotiated price established by the beneficiary's Medicare Part D plan pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, or (B) in consultation with the Secretary of the Office of Policy and Management, at the price that would be paid under the ConnPACE program. Payment shall be made under the ConnPACE program for prescription drugs that are not Medicare Part D drugs, as defined in said act.] |
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| 157 | 157 | | |
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| 158 | 158 | | [(3)] (2) Payment for a replacement prescription under the program shall be made only if the eligible person signs a statement, on such form as the commissioner prescribes and subject to penalty under section 17b-497, that the prescription drug is lost or was stolen or destroyed and the person has made a good faith effort to recover the prescription drug, except that payment for a replacement prescription shall not be made on behalf of a person more than twice in a calendar year. |
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| 159 | 159 | | |
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| 160 | 160 | | (c) Any eligible resident who (1) is insured under a policy, [including an endorsed Medicare prescription drug discount card, which provides full or partial coverage for prescription drugs,] and (2) expects to exhaust such coverage, may apply to participate in the program prior to the exhaustion of such coverage. Such application shall be valid for the applicable income year. To be included in the program, on or after the date the applicant exhausts such coverage, the applicant or the applicant's designee shall notify the department that such coverage is exhausted and, if required by the department, shall submit evidence of exhaustion of coverage. Not later than ten days after an eligible resident submits such evidence, such resident shall be included in the program. The program shall [, except for those beneficiaries with an endorsed Medicare prescription drug discount card,] (A) cover prescriptions that are not covered by any other plan of insurance or assistance available to the eligible resident and that meet the requirements of this chapter, and (B) retroactively cover such prescriptions filled after or concurrently with the exhaustion of such coverage. Nothing in this subsection shall be construed to prevent a resident from applying to participate in the program as otherwise permitted by this chapter and regulations adopted pursuant to this chapter. |
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| 161 | 161 | | |
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| 162 | 162 | | [(d) (1) As a condition of eligibility for participation in the ConnPACE program, a resident with an income at or below one hundred thirty-five per cent of the federal poverty level, who is Medicare Part A or Part B eligible, shall obtain annually an endorsed Medicare prescription drug discount card designated by the Commissioner of Social Services for use in conjunction with the ConnPACE program. The commissioner shall be the authorized representative of such resident for the purpose of enrolling a resident in the transitional assistance program of Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. As the authorized representative for this purpose, the commissioner may sign required forms and enroll such resident in an endorsed Medicare prescription drug discount card on the resident's behalf. Such resident shall have the opportunity to select an endorsed Medicare prescription drug discount card designated by the commissioner for use in conjunction with the ConnPACE program, and shall be notified of such opportunity by the commissioner. In the event that such resident does not select an endorsed Medicare prescription drug discount card designated by the commissioner for use in conjunction with the ConnPACE program within a reasonable period of time, as determined by the commissioner, the department shall enroll the resident in an endorsed Medicare prescription drug discount card designated by the commissioner. The provisions of this subdivision shall remain in effect until the effective date of the Medicare Part D program pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. |
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| 163 | 163 | | |
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| 164 | 164 | | (2) The commissioner may require, as a condition of eligibility for participation in the ConnPACE program, that a resident with an income above one hundred thirty-five per cent of the federal poverty level, who is Medicare Part A or Part B eligible, obtain an endorsed Medicare prescription drug discount card designated by the commissioner for use in conjunction with the ConnPACE program if obtaining such discount card is determined by the commissioner to be cost-effective to the state. In such an event, the commissioner may provide payment for any Medicare prescription drug discount card enrollment fees. The provisions of this subdivision shall remain in effect until the effective date of the Medicare Part D program pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. |
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| 165 | 165 | | |
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| 166 | 166 | | (e) On and after the effective date of the Medicare Part D program pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, enrollment in the Medicare Part D program, for individuals eligible for such program in accordance with said act, shall be a condition of eligibility for the ConnPACE program. The ConnPACE program shall cover the financial costs of Medicare Part D participation for ConnPACE recipients enrolled in Medicare Part D in accordance with subsection (b) of this section. Effective July 1, 2005, a ConnPACE recipient shall, as a condition of eligibility, provide information regarding the recipient's assets and income, as defined by said act, and that of the recipient's spouse, provided said spouse resides in the same household, as required by the Department of Social Services in order to determine the extent of benefits for which the recipient is eligible under Medicare Part D. |
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| 167 | 167 | | |
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| 168 | 168 | | (f) Each ConnPACE applicant or recipient who is eligible for Medicare Part D shall enroll in a Medicare Part D benchmark plan. The Commissioner of Social Services may be the authorized representative of a ConnPACE applicant or recipient for purposes of: (1) Enrolling in a Medicare Part D benchmark plan, (2) submitting an application to the Social Security Administration to obtain the low income subsidy benefit provided under Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, or (3) facilitating the enrollment in a Medicare savings program of any such applicant or recipient who elects to participate in such program. The applicant or recipient shall have the opportunity to select a Medicare Part D benchmark plan and shall be notified of such opportunity by the commissioner. The applicant or recipient, prior to selecting a Medicare Part D benchmark plan, shall have the opportunity to consult with the commissioner, or the commissioner's designated agent, concerning the selection of a Medicare Part D benchmark plan that best meets the prescription drug needs of such applicant or recipient. In the event that such applicant or recipient does not select a Medicare Part D benchmark plan within a reasonable period of time, as determined by the commissioner, the commissioner shall enroll the applicant or recipient in a Medicare Part D benchmark plan designated by the commissioner in accordance with said act. The applicant or recipient shall appoint the commissioner as such applicant's or recipient's representative for the purpose of appealing any denial of Medicare Part D benefits and for any other purpose allowed under said act and deemed necessary by the commissioner.] |
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| 169 | 169 | | |
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| 170 | 170 | | [(g)] (d) The Commissioner of Social Services may adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of subsection (c) of this section. Such regulations may provide for the electronic transmission of relevant coverage information between a pharmacist and the department or between an insurer and the department in order to expedite applications and notice. The commissioner may implement the policies and procedures necessary to carry out the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided notice of intent to adopt the regulations is published not later than twenty days after the date of implementation. Such policies and procedures shall be valid until the time the final regulations are adopted. |
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| 171 | 171 | | |
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| 172 | 172 | | Sec. 18. Section 17b-265f of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 173 | 173 | | |
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| 174 | 174 | | No pharmacy shall claim payment from the Department of Social Services under a medical assistance program administered by the department [or the Medicare Part D Supplemental Needs Fund, established pursuant to section 17b-265e,] for prescription drugs dispensed to individuals who have other prescription drug insurance coverage unless such coverage has been exhausted and the individual is otherwise eligible for such a medical assistance program. [or assistance from the Medicare Part D Supplemental Needs Fund.] The department shall recoup from the submitting pharmacy any claims submitted to and paid by the department when other insurance coverage is available. The department shall investigate a pharmacy that consistently submits ineligible claims for payment to determine whether the pharmacy is in violation of its medical assistance provider agreement or is committing fraud or abuse in the program and based on the findings of such investigation, may take action against such pharmacy, in accordance with state and federal law. |
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| 175 | 175 | | |
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| 176 | 176 | | Sec. 19. Subsection (g) of section 17b-340 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 177 | 177 | | |
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| 178 | 178 | | (g) For the fiscal year ending June 30, 1993, any intermediate care facility for the mentally retarded with an operating cost component of its rate in excess of one hundred forty per cent of the median of operating cost components of rates in effect January 1, 1992, shall not receive an operating cost component increase. For the fiscal year ending June 30, 1993, any intermediate care facility for the mentally retarded with an operating cost component of its rate that is less than one hundred forty per cent of the median of operating cost components of rates in effect January 1, 1992, shall have an allowance for real wage growth equal to thirty per cent of the increase determined in accordance with subsection (q) of section 17-311-52 of the regulations of Connecticut state agencies, provided such operating cost component shall not exceed one hundred forty per cent of the median of operating cost components in effect January 1, 1992. Any facility with real property other than land placed in service prior to October 1, 1991, shall, for the fiscal year ending June 30, 1995, receive a rate of return on real property equal to the average of the rates of return applied to real property other than land placed in service for the five years preceding October 1, 1993. For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the rate of return on real property for property items shall be revised every five years. The commissioner shall, upon submission of a request, allow actual debt service, comprised of principal and interest, in excess of property costs allowed pursuant to section 17-311-52 of the regulations of Connecticut state agencies, provided such debt service terms and amounts are reasonable in relation to the useful life and the base value of the property. For the fiscal year ending June 30, 1995, and any succeeding fiscal year, the inflation adjustment made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies shall not be applied to real property costs. For the fiscal year ending June 30, 1996, and any succeeding fiscal year, the allowance for real wage growth, as determined in accordance with subsection (q) of section 17-311-52 of the regulations of Connecticut state agencies, shall not be applied. For the fiscal year ending June 30, 1996, and any succeeding fiscal year, no rate shall exceed three hundred seventy-five dollars per day unless the commissioner, in consultation with the Commissioner of Developmental Services, determines after a review of program and management costs, that a rate in excess of this amount is necessary for care and treatment of facility residents. For the fiscal year ending June 30, 2002, rate period, the Commissioner of Social Services shall increase the inflation adjustment for rates made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies to update allowable fiscal year 2000 costs to include a three and one-half per cent inflation factor. For the fiscal year ending June 30, 2003, rate period, the commissioner shall increase the inflation adjustment for rates made in accordance with subsection (p) of section 17-311-52 of the regulations of Connecticut state agencies to update allowable fiscal year 2001 costs to include a one and one-half per cent inflation factor, except that such increase shall be effective November 1, 2002, and such facility rate in effect for the fiscal year ending June 30, 2002, shall be paid for services provided until October 31, 2002, except any facility that would have been issued a lower rate effective July 1, 2002, than for the fiscal year ending June 30, 2002, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2002, and have such rate updated effective November 1, 2002, in accordance with applicable statutes and regulations. For the fiscal year ending June 30, 2004, rates in effect for the period ending June 30, 2003, shall remain in effect, except any facility that would have been issued a lower rate effective July 1, 2003, than for the fiscal year ending June 30, 2003, due to interim rate status or agreement with the department shall be issued such lower rate effective July 1, 2003. For the fiscal year ending June 30, 2005, rates in effect for the period ending June 30, 2004, shall remain in effect until September 30, 2004. Effective October 1, 2004, each facility shall receive a rate that is five per cent greater than the rate in effect September 30, 2004. Effective upon receipt of all the necessary federal approvals to secure federal financial participation matching funds associated with the rate increase provided in subdivision (4) of subsection (f) of this section, but in no event earlier than October 1, 2005, and provided the user fee imposed under section 17b-320 is required to be collected, each facility shall receive a rate that is four per cent more than the rate the facility received in the prior fiscal year, except any facility that would have been issued a lower rate effective October 1, 2005, than for the fiscal year ending June 30, 2005, due to interim rate status or agreement with the department, shall be issued such lower rate effective October 1, 2005. Such rate increase shall remain in effect unless: (A) The federal financial participation matching funds associated with the rate increase are no longer available; or (B) the user fee created pursuant to section 17b-320 is not in effect. For the fiscal year ending June 30, 2007, rates in effect for the period ending June 30, 2006, shall remain in effect until September 30, 2006, except any facility that would have been issued a lower rate effective July 1, 2006, than for the fiscal year ending June 30, 2006, due to interim rate status or agreement with the department, shall be issued such lower rate effective July 1, 2006. Effective October 1, 2006, no facility shall receive a rate that is more than three per cent greater than the rate in effect for the facility on September 30, 2006, except any facility that would have been issued a lower rate effective October 1, 2006, due to interim rate status or agreement with the department, shall be issued such lower rate effective October 1, 2006. For the fiscal year ending June 30, 2008, each facility shall receive a rate that is two and nine-tenths per cent greater than the rate in effect for the period ending June 30, 2007, except any facility that would have been issued a lower rate effective July 1, 2007, than for the rate period ending June 30, 2007, due to interim rate status, or agreement with the department, shall be issued such lower rate effective July 1, 2007. For the fiscal year ending June 30, 2009, rates in effect for the period ending June 30, 2008, shall remain in effect until June 30, 2009, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2009, due to interim rate status or agreement with the department, shall be issued such lower rate. For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect for the period ending June 30, 2009, shall remain in effect until June 30, 2011, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 2011, due to interim rate status or agreement with the department, shall be issued such lower rate. For the fiscal years ending June 30, 2012, and June 30, 2013, rates in effect for the period ending June 30, 2011, shall remain in effect until June 30, 2013, except any facility that would have been issued a lower rate for the fiscal year ending June 30, 2012, or the fiscal year ending June 30, 2013, due to interim rate status or agreement with the department, shall be issued such lower rate. |
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| 179 | 179 | | |
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| 180 | 180 | | Sec. 20. (NEW) (Effective July 1, 2011) The Commissioner of Social Services may establish a fee schedule for the payment of any outpatient hospital services under the Medicaid program. |
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| 181 | 181 | | |
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| 182 | 182 | | Sec. 21. Subsection (c) of section 17b-265d of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 183 | 183 | | |
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| 184 | 184 | | (c) A full benefit dually eligible Medicare Part D beneficiary shall be responsible for any Medicare Part D prescription drug copayments imposed pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, in amounts not to exceed fifteen dollars per month. The department shall be responsible for payment, on behalf of such beneficiary, of any Medicare Part D prescription drug copayments in any month in which such copayment amounts exceed [fifteen] twenty-five dollars in the aggregate. |
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| 185 | 185 | | |
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| 186 | 186 | | Sec. 22. Section 17b-260d of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 187 | 187 | | |
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| 188 | 188 | | [(a)] The Commissioner of Social Services shall apply for a home and community-based services waiver pursuant to Section 1915(c) of the Social Security Act that will allow the commissioner to develop and implement a program for the provision of home or community-based services, as defined in 42 CFR 440.180, to not more than [one hundred] fifty persons currently receiving services under the Medicaid program who (1) have tested positive for human immunodeficiency virus or have acquired immune deficiency syndrome, and (2) would remain eligible for Medicaid if admitted to a hospital, nursing facility or intermediate care facility for the mentally retarded, or in the absence of the services that are requested under such waiver, would require the Medicaid covered level of care provided in such facilities. [In accordance with 42 CFR 440.180, such persons shall be eligible to receive services that are deemed necessary by the commissioner to meet their unique needs in order to avoid institutionalization.] |
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| 189 | 189 | | |
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| 190 | 190 | | [(b) If the commissioner fails to submit the application for the waiver to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations by February 1, 2010, the commissioner shall submit a written report to said committees not later than February 2, 2010. The report shall include, but not be limited to: (1) An explanation of the reasons for failing to seek the waiver; and (2) an estimate of the fiscal impact that would result from the approval of the waiver in one calendar year.] |
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| 191 | 191 | | |
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| 192 | 192 | | Sec. 23. Subsection (b) of section 17b-106 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 193 | 193 | | |
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| 194 | 194 | | (b) Effective July 1, [1998] 2011, the commissioner shall provide a state supplement payment for recipients of Medicaid and the federal Supplemental Security Income Program who reside in long-term care facilities sufficient to increase their personal needs allowance to [fifty] sixty dollars per month. Such state supplement payment shall be made to the long-term care facility to be deposited into the personal fund account of each such recipient. [Effective July 1, 1999, and annually thereafter, the commissioner shall increase such allowance to reflect the annual inflation adjustment in Social Security income, if any.] For the purposes of this subsection, "long-term care facility" means a licensed chronic and convalescent nursing home, a chronic disease hospital, a rest home with nursing supervision, an intermediate care facility for the mentally retarded or a state humane institution. |
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| 195 | 195 | | |
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| 196 | 196 | | Sec. 24. Subsection (a) of section 17b-278g of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 197 | 197 | | |
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| 198 | 198 | | (a) To the extent permitted by federal law, no payment shall be provided by the Department of Social Services under the Medicaid program for more than one pair of eyeglasses [per year] every two years. Said department shall administer the payment for eyeglasses and contact lenses as cost effectively as possible. |
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| 199 | 199 | | |
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| 200 | 200 | | Sec. 25. Subsection (e) of section 17b-372 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 201 | 201 | | |
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| 202 | 202 | | (e) Notwithstanding the provisions of subsection (d) of this section, the commissioner shall approve no more than one project. [through June 30, 2011.] The total number of beds under such project shall not exceed two hundred eighty beds. |
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| 203 | 203 | | |
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| 204 | 204 | | Sec. 26. Subsection (b) of section 17b-790a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 205 | 205 | | |
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| 206 | 206 | | (b) The commissioner shall provide assistance to an individual under this section in an amount equal to [seventy-five] fifty per cent of the amount the individual would be eligible to receive under the federal Food and Nutrition Act of 2008, as amended. |
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| 207 | 207 | | |
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| 208 | 208 | | Sec. 27. Section 17b-802 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 209 | 209 | | |
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| 210 | 210 | | (a) The Commissioner of Social Services shall establish, within available appropriations, and administer a security deposit guarantee program for persons who (1) (A) are recipients of temporary family assistance, aid under the state supplement program, or state-administered general assistance, or (B) have a documented showing of financial need, and (2) (A) are residing in emergency shelters or other emergency housing, cannot remain in permanent housing due to any reason specified in subsection (a) of section 17b-808, or are served a [notice to quit] writ, summons and complaint in a summary process action instituted pursuant to chapter 832, or (B) have a rental assistance program or federal Section 8 certificate or voucher. Under such program, the Commissioner of Social Services may provide security deposit guarantees for use by such persons in lieu of a security deposit on a rental dwelling unit. Eligible persons may receive a security deposit guarantee in an amount not to exceed the equivalent of two months' rent on such rental unit. No person may apply for and receive a security deposit guarantee more than once in any [eighteen-month] five-year period without the express authorization of the Commissioner of Social Services, except as provided in subsection (b) of this section. The Commissioner of Social Services may deny eligibility for the security deposit guarantee program to an applicant for whom the commissioner has paid two or more claims by landlords. [during the immediately preceding five-year period.] The Commissioner of Social Services may establish priorities for providing security deposit guarantees to eligible persons described in subparagraphs (A) and (B) of subdivision (2) of this subsection in order to administer the program within available appropriations. |
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| 211 | 211 | | |
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| 212 | 212 | | (b) In the case of any person who qualifies for a guarantee, the Commissioner of Social Services, or any emergency shelter under contract with the Department of Social Services to assist in the administration of the security deposit guarantee program established pursuant to subsection (a) of this section, may execute a written agreement to pay the landlord for any damages suffered by the landlord due to the tenant's failure to comply with such tenant's obligations as defined in section 47a-21, provided the amount of any such payment shall not exceed the amount of the requested security deposit. Notwithstanding the provisions of subsection (a) of this section, if a person who has previously received a grant for a security deposit or a security deposit guarantee becomes eligible for a subsequent security deposit guarantee within [eighteen months] five years after a claim has been paid on a prior security deposit guarantee, such person may receive a security deposit guarantee. The amount of the subsequent security deposit guarantee for which such person would otherwise have been eligible shall be reduced by (1) any amount of a previous grant which has not been returned to the department pursuant to section 47a-21, or (2) the amount of any payment made to the landlord for damages pursuant to this subsection. |
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| 213 | 213 | | |
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| 214 | 214 | | (c) Any payment made pursuant to this section to any person receiving temporary family assistance, aid under the state supplement program or state-administered general assistance shall not be deducted from the amount of assistance to which the recipient would otherwise be entitled. |
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| 215 | 215 | | |
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| 216 | 216 | | (d) On and after July 1, 2000, no special need or special benefit payments shall be made by the commissioner for security deposits from the temporary family assistance, state supplement, or state-administered general assistance programs. |
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| 217 | 217 | | |
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| 218 | 218 | | (e) The Commissioner of Social Services may, within available appropriations, on a case-by-case basis, provide a security deposit grant to a person eligible for the security deposit guarantee program established under subsection (a) of this section, in an amount not to exceed the equivalent of one month's rent on such rental unit provided the commissioner determines that emergency circumstances exist which threaten the health, safety or welfare of a child who resides with such person. Such person shall not be eligible for more than one such grant without the authorization of said commissioner. Nothing in this section shall preclude the approval of such one-month security deposit grant in conjunction with a one-month security deposit guarantee. |
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| 219 | 219 | | |
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| 220 | 220 | | (f) The Commissioner of Social Services may provide a security deposit grant to a person receiving such grant through any emergency shelter under an existing contract with the Department of Social Services to assist in the administration of the security deposit program, but in no event shall a payment be authorized after October 1, 2000. Nothing in this section shall preclude the commissioner from entering into a contract with one or more emergency shelters for the purpose of issuing security deposit guarantees. |
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| 221 | 221 | | |
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| 222 | 222 | | (g) A landlord may submit a claim for damages not later than forty-five days after the date of termination of the tenancy. Payment shall be made only for a claim that includes receipts for repairs made. No claim shall be paid for an apartment from which a tenant vacated because substandard conditions made the apartment uninhabitable, as determined by a local, state or federal regulatory agency. |
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| 223 | 223 | | |
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| 224 | 224 | | (h) Any person with income exceeding one hundred fifty per cent of the federal poverty level who is found eligible to receive a security deposit guarantee under this section shall contribute ten per cent of one month's rent to the payment of the security deposit. The commissioner may waive such payment for good cause. |
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| 225 | 225 | | |
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| 226 | 226 | | [(g)] (i) The Commissioner of Social Services shall adopt regulations, in accordance with the provisions of chapter 54, to administer the program established pursuant to this section and to set eligibility criteria for the program, but may implement the program until June 30, 2003, while in the process of adopting such regulations provided notice of intent to adopt the regulations is published in the Connecticut Law Journal within twenty days after implementation. |
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| 227 | 227 | | |
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| 228 | 228 | | Sec. 28. Section 17b-749a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 229 | 229 | | |
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| 230 | 230 | | (a) The [Commissioner of Social Services, in consultation with the] Commissioner of Education [,] shall establish, within available appropriations, a program to (1) purchase directly or provide subsidies to parents to purchase child day care services provided by any elementary or secondary school, nursery school, preschool, day care center, group day care home, family day care home, family resource center, Head Start program, or local or regional board of education, provided, if the commissioner purchases such services directly, he shall give preference to purchasing from providers of full-day and year-round programs; and (2) award grants to providers of school readiness programs, as defined in section 10-16p, to increase the hours of operation of their programs in order to provide child care for children attending such programs. The commissioner, for purposes of subdivision (1) of this subsection, [shall] may model the program on the program established pursuant to section 17b-749. |
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| 231 | 231 | | |
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| 232 | 232 | | (b) No funds received by a provider pursuant to this section shall be used to supplant federal funding received for early childhood education on behalf of children in an early childhood education program. |
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| 233 | 233 | | |
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| 234 | 234 | | (c) The [Commissioners of Social Services and] Commissioner of Education shall: (1) Coordinate the development of a range of alternative programs to meet the needs of all children; (2) foster partnerships between school districts and private organizations; (3) provide information and assistance to parents in selecting an appropriate school readiness program; and (4) work to ensure, to the extent possible, that school readiness programs allow open enrollment for all children and allow families receiving benefits for such a program to choose a public or accredited private program. |
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| 235 | 235 | | |
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| 236 | 236 | | Sec. 29. Subsection (a) of section 17b-749c of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 237 | 237 | | |
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| 238 | 238 | | (a) The [Commissioner of Social Services, in consultation with the] Commissioner of Education [,] shall establish a program, within available appropriations, to provide, on a competitive basis, supplemental quality enhancement grants to providers of child day care services or providers of school readiness programs pursuant to section 10-16p and section 10-16u. Child day care providers and school readiness programs may apply for a supplemental quality enhancement grant at such time and on such form as the Commissioner of [Social Services] Education prescribes. |
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| 239 | 239 | | |
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| 240 | 240 | | Sec. 30. Section 12-263a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011): |
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| 241 | 241 | | |
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| 242 | 242 | | As used in sections 12-263a to 12-263e, inclusive, as amended by this act: |
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| 243 | 243 | | |
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| 244 | 244 | | (1) "Hospital" means any health care facility or institution, as defined in section 19a-630, which is licensed as a short-term general hospital by the Department of Public Health but does not include (A) any hospital which, on October 1, 1997, is within the class of hospitals licensed by the department as children's general hospitals, or (B) a short-term acute hospital operated exclusively by the state other than a short-term acute hospital operated by the state as a receiver pursuant to chapter 920; |
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| 245 | 245 | | |
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| 246 | 246 | | [(2) "Gross revenue" means the amount of a hospital's total charges for all patient care services minus any refunds resulting from errors or overcharges; |
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| 247 | 247 | | |
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| 248 | 248 | | (3) "Contractual allowance" means the percentage amount of discounts that are provided to nongovernmental payers pursuant to subsections (c), (d) and (e) of section 19a-646; |
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| 249 | 249 | | |
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| 250 | 250 | | (4) "Uncompensated care" means the cost of care that is written off as a bad debt or provided free under a free care policy that has been approved by the Office of Health Care Access division of the Department of Public Health; |
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| 251 | 251 | | |
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| 252 | 252 | | (5) "Other allowances" means any financial requirements, as authorized by the Office of Health Care Access division of the Department of Public Health, of a hospital resulting from circumstances including, but not limited to, an insurance settlement of a liability case or satisfaction of a lien or encumbrance, any difference between charges for employee self-insurance and related expenses. For fiscal years commencing on and after October 1, 1994, "other allowances" means the amount of any difference between charges for employee self-insurance and related expenses determined using the hospital's overall relationship of costs to charges as determined by the Office of Health Care Access division of the Department of Public Health; |
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| 253 | 253 | | |
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| 254 | 254 | | (6) "Net revenue" means the amount of a hospital's gross revenue minus the hospital's (A) contractual allowances, (B) the difference between government charges and government payments, (C) uncompensated care and (D) other allowances; |
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| 255 | 255 | | |
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| 256 | 256 | | (7) "Hospital gross earnings" means the amount of a hospital's net revenue minus (A) the amount that is projected to be received by the hospital from the federal government for Medicare patients, based on the hospital's budget authorization, and (B) the amount that is projected to be received by the hospital from the Department of Social Services, based on the hospital's budget authorization; |
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| 257 | 257 | | |
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| 258 | 258 | | (8) "Patient care services" means therapeutic and diagnostic medical services provided by the hospital to inpatients and outpatients, including tangible personal property transferred in connection with such services.] |
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| 259 | 259 | | |
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| 260 | 260 | | (2) "Net patient revenue" means the amount of a hospital's gross revenue excluding the amount received by the hospital from the federal government for Medicare patients; |
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| 261 | 261 | | |
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| 262 | 262 | | (3) "Commissioner" means the Commissioner of Revenue Services; |
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| 263 | 263 | | |
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| 264 | 264 | | (4) "Department" means the Department of Revenue Services. |
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| 265 | 265 | | |
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| 266 | 266 | | Sec. 31. Section 12-263b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011): |
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| 267 | 267 | | |
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| 268 | 268 | | [There is hereby imposed on the hospital gross earnings of each hospital in this state a tax (1) at the rate of eleven per cent of its hospital gross earnings in each taxable quarter for taxable quarters commencing prior to October 1, 1996; (2) at the rate of nine and one-fourth per cent of its hospital gross earnings in each taxable quarter commencing on or after October 1, 1996, and prior to October 1, 1997; (3) at the rate of eight and one-fourth per cent of its hospital gross earnings in each taxable quarter commencing on or after October 1, 1997, and prior to October 1, 1998; (4) at the rate of seven and one-fourth per cent of its hospital gross earnings in each taxable quarter commencing on or after October 1, 1998, and prior to October 1, 1999; and (5) at the rate of four and one-half per cent of its hospital gross earnings in each taxable quarter commencing on or after October 1, 1999, and prior to April 1, 2000. The hospital gross earnings of each hospital in this state shall not be subject to the provisions of this chapter with respect to calendar quarters commencing on or after April 1, 2000.] |
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| 269 | 269 | | |
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| 270 | 270 | | (a) For each calendar quarter commencing on or after July 1, 2011, there is hereby imposed a tax on the net patient revenue of each hospital in this state to be paid each calendar quarter at the maximum rate allowed under federal law. |
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| 271 | 271 | | |
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| 272 | 272 | | (b) Each hospital shall, on or before the last day of January, April, July and October of each year, render to the Commissioner of Revenue Services a return, on forms prescribed or furnished by the Commissioner of Revenue Services and signed by one of its principal officers, stating specifically the name and location of such hospital, and the [amounts of its hospital gross earnings, its net revenue and its gross revenue] amount of its net patient revenue for the calendar quarter ending the last day of the preceding month. Payment shall be made with such return. Each hospital shall file such return electronically with the department and make such payment by electronic funds transfer in the manner provided by chapter 228g, irrespective of whether the hospital would otherwise have been required to file such return electronically or to make such payment by electronic funds transfer under the provisions of chapter 228g. |
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| 273 | 273 | | |
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| 274 | 274 | | Sec. 32. Section 12-263c of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011): |
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| 275 | 275 | | |
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| 276 | 276 | | (a) If any hospital fails to pay the amount of tax reported to be due on its return within the time specified under the provisions of section 12-263b, as amended by this act, there shall be imposed a penalty equal to ten per cent of such amount due and unpaid, or fifty dollars, whichever is greater. The tax shall bear interest at the rate of one per cent per month or fraction thereof, from the due date of such tax until the date of payment. |
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| 277 | 277 | | |
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| 278 | 278 | | (b) If any hospital has not made its return within one month after the time specified in section 12-263b, as amended by this act, the Commissioner of Revenue Services may make such return at any time thereafter, according to the best information obtainable and according to the form prescribed. To the tax imposed upon the basis of such return, there shall be added an amount equal to ten per cent of such tax, or fifty dollars, whichever is greater. The tax shall bear interest at the rate of one per cent per month or fraction thereof, from the due date of such tax until the date of payment. |
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| 279 | 279 | | |
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| 280 | 280 | | (c) Subject to the provisions of section 12-3a, the commissioner may waive all or part of the penalties provided under this section when it is proven to his satisfaction that the failure to pay any tax on time was due to reasonable cause and was not intentional or due to neglect. |
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| 281 | 281 | | |
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| 282 | 282 | | (d) The commissioner shall notify the Commissioner of Social Services of any amount delinquent under sections 12-263a to 12-263e, inclusive, as amended by this act, and, upon receipt of such notice, the Commissioner of Social Services shall deduct and withhold such amount from amounts otherwise payable by the Department of Social Services to the delinquent hospital. |
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| 283 | 283 | | |
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| 284 | 284 | | Sec. 33. Section 12-263d of the general statutes is amended by adding subsection (c) as follows (Effective July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011): |
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| 285 | 285 | | |
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| 286 | 286 | | (NEW) (c) The commissioner may enter into an agreement with the Commissioner of Social Services delegating to the Commissioner of Social Services the authority to examine the records and returns of any hospital subject to the tax imposed under section 12-263b of the general statutes, as amended by this act, and to determine whether such tax has been underpaid or overpaid. If such authority is so delegated, examinations of such records and returns by the Commissioner of Social Services and determinations by the Commissioner of Social Services that such tax has been underpaid or overpaid shall have the same effect as similar examinations or determinations made by the Commissioner of Revenue Services. |
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| 287 | 287 | | |
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| 288 | 288 | | Sec. 34. (NEW) (Effective July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011) At the close of each fiscal year commencing with the fiscal year ending June 30, 2012, the Comptroller is authorized to record as revenue for such fiscal year the amount of tax imposed under the provisions of section 12-263b of the general statutes, as amended by this act, that is received by the Commissioner of Revenue Services not later than five business days after the last day of July immediately following the end of such fiscal year. |
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| 289 | 289 | | |
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| 290 | 290 | | Sec. 35. Section 17b-321 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011): |
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| 291 | 291 | | |
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| 292 | 292 | | (a) On or before July 1, 2005, and on or before July first biennially thereafter, the Commissioner of Social Services shall determine the amount of the user fee and promptly notify the commissioner and nursing homes of such amount. The user fee shall be (1) the sum of each nursing home's anticipated nursing home net revenue, including, but not limited to, its estimated net revenue from any increases in Medicaid payments, during the twelve-month period ending on June thirtieth of the succeeding calendar year, (2) which sum shall be multiplied by a percentage as determined by the Secretary of the Office of Policy and Management, in consultation with the Commissioner of Social Services, provided before January 1, 2008, such percentage shall not exceed six per cent, [and] on and after January 1, 2008, and prior to October 1, 2011, such percentage shall not exceed five and one-half per cent, and on and after October 1, 2011, such percentage shall not exceed the maximum allowed under federal law, and (3) which product shall be divided by the sum of each nursing home's anticipated resident days during the twelve-month period ending on June thirtieth of the succeeding calendar year. The Commissioner of Social Services, in anticipating nursing home net revenue and resident days, shall use the most recently available nursing home net revenue and resident day information. [On or before July 1, 2007, the Commissioner of Social Services shall report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies and human services on the detrimental effects, if any, that a biennial determination of the user fee may have on private payors.] |
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| 293 | 293 | | |
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| 294 | 294 | | (b) Upon approval of the waiver of federal requirements for uniform and broad-based user fees in accordance with 42 CFR 433.68 pursuant to section 17b-323, the Commissioner of Social Services shall redetermine the amount of the user fee and promptly notify the commissioner and nursing homes of such amount. The user fee shall be (1) the sum of each nursing home's anticipated nursing home net revenue, including, but not limited to, its estimated net revenue from any increases in Medicaid payments, during the twelve-month period ending on June thirtieth of the succeeding calendar year but not including any such anticipated net revenue of any nursing home exempted from such user fee due to waiver of federal requirements pursuant to section 17b-323, (2) which sum shall be multiplied by a percentage as determined by the Secretary of the Office of Policy and Management, in consultation with the Commissioner of Social Services, provided before January 1, 2008, such percentage shall not exceed six per cent, [and] on and after January 1, 2008, and prior to October 1, 2011, such percentage shall not exceed five and one-half per cent, and on and after October 1, 2011, such percentage shall not exceed the maximum allowed under federal law, and (3) which product shall be divided by the sum of each nursing home's anticipated resident days, but not including the anticipated resident days of any nursing home exempted from such user fee due to waiver of federal requirements pursuant to section 17b-323. Notwithstanding the provisions of this subsection, the amount of the user fee for each nursing home licensed for more than two hundred thirty beds or owned by a municipality shall be equal to the amount necessary to comply with federal provider tax uniformity waiver requirements as determined by the Commissioner of Social Services. The Commissioner of Social Services may increase retroactively the user fee for nursing homes not licensed for more than two hundred thirty beds and not owned by a municipality to the effective date of waiver of said federal requirements to offset user fee reductions necessary to meet the federal waiver requirements. On or before July 1, 2005, and biennially thereafter, the Commissioner of Social Services shall determine the amount of the user fee in accordance with this subsection. The Commissioner of Social Services, in anticipating nursing home net revenue and resident days, shall use the most recently available nursing home net revenue and resident day information. [On or before July 1, 2007, the Commissioner of Social Services shall report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies and human services on the detrimental effects, if any, that a biennial determination of the user fee may have on private payors.] |
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| 295 | 295 | | |
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| 296 | 296 | | (c) (1) Following a redetermination of the resident day user fee by the Commissioner of Social Services pursuant to subsection (b) of this section, the Commissioner of Social Services shall notify the commissioner of the identity of (A) any nursing home subsequently exempted from the resident day user fee due to the waiver of federal requirements pursuant to section 17b-323 and the effective date of such waiver, (B) any nursing home licensed for more than two hundred thirty beds or owned by a municipality and the effective date of any change in its user fee, and (C) any nursing home for which the user fee is retroactively increased pursuant to subsection (b) of this section and the effective date of such increase. The Commissioner of Social Services shall provide notice of any such retroactive user fee increase to each nursing home so affected. |
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| 297 | 297 | | |
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| 298 | 298 | | (2) Upon being notified by the Commissioner of Social Services, the commissioner shall refund or credit to any nursing home subsequently exempted from the resident day user fee due to the waiver of federal requirements pursuant to section 17b-323 any resident day user fee collected from such home. No interest shall be payable on the amount of such refund or credit. Any such nursing home shall refund any fees paid by or on behalf of any resident to the party making such payment. |
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| 299 | 299 | | |
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| 300 | 300 | | (3) Upon being notified by the Commissioner of Social Services, the commissioner shall refund or credit to any nursing home licensed for more than two hundred thirty beds or owned by a municipality any resident day user fee collected from such home in excess of the resident day user fee that would have been payable had the user fee, as redetermined by the Commissioner of Social Services, been used in calculating the nursing home's resident day user fee. No interest shall be payable on the amount of such refund or credit. |
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| 301 | 301 | | |
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| 302 | 302 | | (4) Upon being notified by the Commissioner of Social Services, the commissioner shall notify any nursing home for which the user fee is retroactively increased pursuant to subsection (b) of this section of the additional amount of resident day user fee due and owing from such nursing home. Such a notice of additional amount due and owing to the commissioner shall not be treated as a notice of deficiency assessment by the commissioner nor shall the nursing home have, based on such notice of additional amount due, any right of protest or appeal to the commissioner as in the case of such a deficiency assessment. No interest shall be payable on such additional amount to the extent such additional amount is paid on or before the last day of the month next succeeding the month during which the Commissioner of Social Services provided notice of such retroactive user fee increase to such nursing home. |
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| 303 | 303 | | |
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| 304 | 304 | | Sec. 36. (NEW) (Effective July 1, 2011) (a) For purposes of this section and section 37 of this act: |
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| 305 | 305 | | |
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| 306 | 306 | | (1) "Commissioner" means the Commissioner of Revenue Services; |
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| 307 | 307 | | |
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| 308 | 308 | | (2) "Department" means the Department of Revenue Services; |
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| 309 | 309 | | |
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| 310 | 310 | | (3) "Intermediate care facility for the mentally retarded" or "intermediate care facility" means a residential facility for the mentally retarded which is certified to meet the requirements of 42 CFR 442, Subpart C and, in the case of a private facility, licensed pursuant to section 17a-227 of the general statutes; |
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| 311 | 311 | | |
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| 312 | 312 | | (4) "Resident day" means a day of intermediate care facility residential care provided to an individual and includes the day a resident is admitted and any day for which the intermediate care facility is eligible for payment for reserving a resident's bed due to hospitalization or temporary leave and for the date of death. For purposes of this subdivision, a day of care shall be the period of time between the census-taking hour in a facility on two successive calendar days. "Resident day" does not include the day a resident is discharged; |
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| 313 | 313 | | |
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| 314 | 314 | | (5) "Intermediate care facility for the mentally retarded net revenue" means amounts billed by an intermediate care facility for all services provided, including room, board and ancillary services, minus (A) contractual allowances, (B) payer discounts, (C) charity care, and (D) bad debts; and |
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| 315 | 315 | | |
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| 316 | 316 | | (6) "Contractual allowances" means the amount of discounts allowed by an intermediate care facility to certain payers from amounts billed for room, board and ancillary services. |
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| 317 | 317 | | |
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| 318 | 318 | | (b) (1) For each calendar quarter commencing on or after July 1, 2011, there is hereby imposed a resident day user fee on each intermediate care facility for the mentally retarded in this state, which fee shall be the product of the facility's total resident days during the calendar quarter multiplied by the user fee, as determined by the Commissioner of Social Services pursuant to section 37 of this act. |
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| 319 | 319 | | |
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| 320 | 320 | | (2) Each intermediate care facility for the mentally retarded shall, on or before the last day of January, April, July and October of each year, render to the commissioner a return, on forms prescribed or furnished by the commissioner, stating the intermediate care facility's total resident days during the calendar quarter ending on the last day of the preceding month and stating such other information as the commissioner deems necessary for the proper administration of the provisions of this section. The resident day user fee imposed under this section shall be due and payable on the due date of such return. Each intermediate care facility shall be required to file such return electronically with the department and to make such payment by electronic funds transfer in the manner provided by chapter 228g of the general statutes, irrespective of whether such facility would have otherwise been required to file such return electronically or to make such payment by electronic funds transfer under the provisions of chapter 228g of the general statutes. |
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| 321 | 321 | | |
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| 322 | 322 | | (c) Whenever such resident day user fee is not paid when due, a penalty of ten per cent of the amount due or fifty dollars, whichever is greater, shall be imposed, and interest at the rate of one per cent per month or a fraction thereof shall accrue on such user fee from the due date of such user fee until the date of payment. |
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| 323 | 323 | | |
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| 324 | 324 | | (d) The commissioner shall notify the Commissioner of Social Services of any amount delinquent under section 37 of this act and, upon receipt of such notice, the Commissioner of Social Services shall deduct and withhold such amount from amounts otherwise payable by the Department of Social Services to the delinquent facility. |
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| 325 | 325 | | |
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| 326 | 326 | | (e) The provisions of section 12-548 of the general statutes, sections 12-550 to 12-554, inclusive, of the general statutes and section 12-555a of the general statutes shall apply to the provisions of this section in the same manner and with the same force and effect as if the language of said sections had been incorporated in full into this section and had expressly referred to the user fee imposed under this section, except to the extent that any provision is inconsistent with a provision in this section. For purposes of section 12-39g of the general statutes, the resident day user fee shall be treated as a tax. |
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| 327 | 327 | | |
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| 328 | 328 | | (f) The commissioner may enter into an agreement with the Commissioner of Social Services delegating to the Commissioner of Social Services the authority to examine the records and returns of any intermediate care facility for the mentally retarded in this state subject to the resident day user fee imposed under this section and to determine whether such user fee has been underpaid or overpaid. If such authority is so delegated, examinations of such records and returns by the Commissioner of Social Services and determinations by the Commissioner of Social Services that such user fee has been underpaid or overpaid shall have the same effect as similar examinations or determinations made by the Commissioner of Revenue Services. |
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| 329 | 329 | | |
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| 330 | 330 | | (g) (1) The commissioner shall not collect the resident day user fee pursuant to this section until the Commissioner of Social Services informs the commissioner that all the necessary federal approvals are in effect to secure federal financial participation matching funds associated with any authorized facility rate increases. |
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| 331 | 331 | | |
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| 332 | 332 | | (2) The commissioner shall cease to collect the resident day user fee pursuant to this section if the Commissioner of Social Services informs the commissioner that the federal approvals described in subdivision (1) of this subsection are withheld or withdrawn. |
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| 333 | 333 | | |
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| 334 | 334 | | Sec. 37. (NEW) (Effective July 1, 2011) On or before July 1, 2011, and on or before July first biennially thereafter, the Commissioner of Social Services shall determine the amount of the user fee and promptly notify the commissioner and the intermediate care facilities for the mentally retarded of such amount. The user fee shall be (1) the sum of each facility's anticipated net revenue, including, but not limited to, its estimated net revenue from any increases in Medicaid payments during the twelve-month period ending on June thirtieth of the succeeding calendar year, (2) which sum shall be multiplied by a percentage as determined by the Secretary of the Office of Policy and Management, in consultation with the Commissioner of Social Services, provided, before October 1, 2011, such percentage shall not exceed five and one-half per cent and, on and after October 1, 2011, such percentage shall not exceed the maximum amount allowed under federal law, and (3) which product shall be divided by the sum of each facility's anticipated resident days during the twelve-month period ending on June thirtieth of the succeeding calendar year. The Commissioner of Social Services, in anticipating facility net revenue and resident days, shall use the most recently available facility net revenue and resident day information. |
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| 335 | 335 | | |
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| 336 | 336 | | Sec. 38. (NEW) (Effective July 1, 2011) At the close of each fiscal year commencing with the fiscal year ending June 30, 2012, the Comptroller is authorized to record as revenue for such fiscal year the amount of the user fee imposed under the provisions of section 36 of this act that is received by the Commissioner of Revenue Services not later than five business days after the last day of July immediately following the end of such fiscal year. |
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| 337 | 337 | | |
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| 338 | 338 | | Sec. 39. (NEW) (Effective July 1, 2011) The Commissioner of Social Services, pursuant to section 17b-10 of the general statutes, may implement policies and procedures necessary to administer the provisions of this act, while in the process of adopting such policies and procedures in regulation form, provided the commissioner prints notice of intent to adopt regulations in the Connecticut Law Journal not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted. |
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| 339 | 339 | | |
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| 340 | 340 | | Sec. 40. Section 17b-261a of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage): |
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| 341 | 341 | | |
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| 342 | 342 | | (a) Any transfer or assignment of assets resulting in the imposition of a penalty period shall be presumed to be made with the intent, on the part of the transferor or the transferee, to enable the transferor to obtain or maintain eligibility for medical assistance. This presumption may be rebutted only by clear and convincing evidence that the transferor's eligibility or potential eligibility for medical assistance was not a basis for the transfer or assignment. |
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| 343 | 343 | | |
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| 344 | 344 | | (b) Any transfer or assignment of assets resulting in the establishment or imposition of a penalty period shall create a debt, as defined in section 36a-645, that shall be due and owing by the transferor or transferee to the Department of Social Services in an amount equal to the amount of the medical assistance provided to or on behalf of the transferor on or after the date of the transfer of assets, but said amount shall not exceed the fair market value of the assets at the time of transfer. The Commissioner of Social Services, the Commissioner of Administrative Services and the Attorney General shall have the power or authority to seek administrative, legal or equitable relief as provided by other statutes or by common law. |
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| 345 | 345 | | |
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| 346 | 346 | | (c) The Commissioner of Social Services may waive the imposition of a penalty period when the transferor (1) in accordance with the provisions of section 3025.25 of the department's Uniform Policy Manual, suffers from dementia at the time of application for medical assistance and cannot explain transfers that would otherwise result in the imposition of a penalty period; or (2) suffered from dementia at the time of the transfer; or (3) was exploited into making such a transfer due to dementia. Waiver of the imposition of a penalty period does not prohibit the establishment of a debt in accordance with subsection (b) of this section. |
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| 347 | 347 | | |
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| 348 | 348 | | (d) An institutionalized individual shall not be penalized for the transfer of an asset if the entire amount of the transferred asset is returned to the institutionalized individual. The partial return of a transferred asset shall not result in a reduced penalty period. |
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| 349 | 349 | | |
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| 350 | 350 | | (1) If there are multiple transfers of assets by the institutionalized individual to the same or different transferees, a return of anything less than the total amount of the transferred assets from all of the separate transferees shall not constitute a return of the entire amount of the transferred assets. |
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| 351 | 351 | | |
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| 352 | 352 | | (2) If the circumstances surrounding the transfer of an asset and return of the entire amount of the asset to the institutionalized individual indicates to the Department of Social Services that such individual, such individual's spouse or such individual's authorized representative intended, from the time the asset was transferred, that the transferee would subsequently return the asset to such individual, such individual's spouse or such individual's authorized representative for the purpose of altering the start of the penalty period or shifting nursing facility costs, that may have been borne by such individual, to the Medicaid program, the entire amount of the returned asset shall be considered available to such individual from the date of transfer. If such individual demonstrates to the department that the purpose of the transfer and its subsequent return was not to alter the penalty period or qualify such individual for Medicaid eligibility, the entire amount of the returned asset is considered available to the individual from the date of the return of the transferred asset. |
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| 353 | 353 | | |
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| 354 | 354 | | (3) The conveyance and subsequent return of an asset for the purpose of shifting costs to the Medicaid program shall be regarded as a trust-like device. Such asset shall be considered available for the purpose of determining Medicaid eligibility. |
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| 355 | 355 | | |
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| 356 | 356 | | [(d)] (e) The Commissioner of Social Services, pursuant to section 17b-10, shall implement the policies and procedures necessary to carry out the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided notice of intent to adopt regulations is published in the Connecticut Law Journal not later than twenty days after implementation. Such policies and procedures shall be valid until the time final regulations are effective. |
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| 357 | 357 | | |
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| 358 | 358 | | Sec. 41. Section 17b-28d of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage): |
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| 359 | 359 | | |
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| 360 | 360 | | The Commissioner of Social Services, in consultation with the Commissioner of Education, shall submit to the Centers for Medicare and Medicaid Services an amendment to the state Medicaid plan [required by Title XIX of the Social Security Act to enhance federal financial participation for Medicaid] concerning school-based child health services provided to Medicaid enrolled children requiring special education pursuant to an individualized education plan. [The amendment shall propose (1) the establishment of either a simplified cost-based or fixed fee method of determining state expenditures for eligible Medicaid services provided to such children, and (2) the replacement of the annual activity cost reports for all school-based child health services provided to such children. Any fixed fee established by the Department of Social Services shall be a per diem or monthly rate per child and shall reflect reimbursable administrative expenses.] Such amendment to the Medicaid plan shall maintain and enhance, to the extent permitted, federal financial participation associated with such costs through a service-specific rate method. |
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| 361 | 361 | | |
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| 362 | 362 | | Sec. 42. Sections 17b-239a, 17b-261k, 17b-371, 17b-265e, 17b-424 and 17b-492a of the general statutes are repealed. (Effective July 1, 2011) |
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| 363 | 363 | | |
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| 364 | 364 | | |
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| 365 | 365 | | |
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| 366 | 366 | | |
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| 367 | 367 | | This act shall take effect as follows and shall amend the following sections: |
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| 368 | 368 | | Section 1 July 1, 2011 17b-340(f)(4) |
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| 369 | 369 | | Sec. 2 July 1, 2011 17b-280(a) |
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| 370 | 370 | | Sec. 3 July 1, 2011 17b-104(b) |
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| 371 | 371 | | Sec. 4 July 1, 2011 17b-106(a) |
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| 372 | 372 | | Sec. 5 July 1, 2011 17b-311 |
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| 373 | 373 | | Sec. 6 July 1, 2011 New section |
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| 374 | 374 | | Sec. 7 July 1, 2011 New section |
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| 375 | 375 | | Sec. 8 July 1, 2011 17b-244(a) |
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| 376 | 376 | | Sec. 9 July 1, 2011 17b-340(h)(1) |
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| 377 | 377 | | Sec. 10 July 1, 2011 New section |
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| 378 | 378 | | Sec. 11 July 1, 2011 19a-180(a) |
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| 379 | 379 | | Sec. 12 July 1, 2011 19a-175(11) |
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| 380 | 380 | | Sec. 13 July 1, 2011 17b-28e |
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| 381 | 381 | | Sec. 14 July 1, 2011 17b-342(i)(1) and (2) |
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| 382 | 382 | | Sec. 15 July 1, 2011 19a-495a |
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| 383 | 383 | | Sec. 16 July 1, 2011 17b-490 |
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| 384 | 384 | | Sec. 17 July 1, 2011 17b-492 |
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| 385 | 385 | | Sec. 18 July 1, 2011 17b-265f |
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| 386 | 386 | | Sec. 19 July 1, 2011 17b-340(g) |
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| 387 | 387 | | Sec. 20 July 1, 2011 New section |
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| 388 | 388 | | Sec. 21 July 1, 2011 17b-265d(c) |
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| 389 | 389 | | Sec. 22 July 1, 2011 17b-260d |
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| 390 | 390 | | Sec. 23 July 1, 2011 17b-106(b) |
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| 391 | 391 | | Sec. 24 July 1, 2011 17b-278g(a) |
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| 392 | 392 | | Sec. 25 July 1, 2011 17b-372(e) |
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| 393 | 393 | | Sec. 26 July 1, 2011 17b-790a(b) |
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| 394 | 394 | | Sec. 27 July 1, 2011 17b-802 |
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| 395 | 395 | | Sec. 28 July 1, 2011 17b-749a |
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| 396 | 396 | | Sec. 29 July 1, 2011 17b-749c(a) |
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| 397 | 397 | | Sec. 30 July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 12-263a |
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| 398 | 398 | | Sec. 31 July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 12-263b |
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| 399 | 399 | | Sec. 32 July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 12-263c |
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| 400 | 400 | | Sec. 33 July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 12-263d |
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| 401 | 401 | | Sec. 34 July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 New section |
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| 402 | 402 | | Sec. 35 July 1, 2011 17b-321 |
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| 403 | 403 | | Sec. 36 July 1, 2011 New section |
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| 404 | 404 | | Sec. 37 July 1, 2011 New section |
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| 405 | 405 | | Sec. 38 July 1, 2011 New section |
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| 406 | 406 | | Sec. 39 July 1, 2011 New section |
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| 407 | 407 | | Sec. 40 from passage 17b-261a |
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| 408 | 408 | | Sec. 41 from passage 17b-28d |
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| 409 | 409 | | Sec. 42 July 1, 2011 Repealer section |
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| 410 | 410 | | |
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| 411 | 411 | | This act shall take effect as follows and shall amend the following sections: |
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| 412 | 412 | | |
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| 413 | 413 | | Section 1 |
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| 414 | 414 | | |
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| 415 | 415 | | July 1, 2011 |
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| 416 | 416 | | |
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| 417 | 417 | | 17b-340(f)(4) |
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| 418 | 418 | | |
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| 419 | 419 | | Sec. 2 |
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| 420 | 420 | | |
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| 421 | 421 | | July 1, 2011 |
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| 422 | 422 | | |
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| 423 | 423 | | 17b-280(a) |
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| 424 | 424 | | |
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| 425 | 425 | | Sec. 3 |
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| 426 | 426 | | |
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| 427 | 427 | | July 1, 2011 |
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| 428 | 428 | | |
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| 429 | 429 | | 17b-104(b) |
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| 430 | 430 | | |
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| 431 | 431 | | Sec. 4 |
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| 432 | 432 | | |
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| 433 | 433 | | July 1, 2011 |
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| 434 | 434 | | |
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| 435 | 435 | | 17b-106(a) |
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| 436 | 436 | | |
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| 437 | 437 | | Sec. 5 |
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| 438 | 438 | | |
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| 439 | 439 | | July 1, 2011 |
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| 440 | 440 | | |
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| 441 | 441 | | 17b-311 |
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| 442 | 442 | | |
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| 443 | 443 | | Sec. 6 |
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| 444 | 444 | | |
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| 445 | 445 | | July 1, 2011 |
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| 446 | 446 | | |
|---|
| 447 | 447 | | New section |
|---|
| 448 | 448 | | |
|---|
| 449 | 449 | | Sec. 7 |
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| 450 | 450 | | |
|---|
| 451 | 451 | | July 1, 2011 |
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| 452 | 452 | | |
|---|
| 453 | 453 | | New section |
|---|
| 454 | 454 | | |
|---|
| 455 | 455 | | Sec. 8 |
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| 456 | 456 | | |
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| 457 | 457 | | July 1, 2011 |
|---|
| 458 | 458 | | |
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| 459 | 459 | | 17b-244(a) |
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| 460 | 460 | | |
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| 461 | 461 | | Sec. 9 |
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| 462 | 462 | | |
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| 463 | 463 | | July 1, 2011 |
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| 464 | 464 | | |
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| 465 | 465 | | 17b-340(h)(1) |
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| 466 | 466 | | |
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| 467 | 467 | | Sec. 10 |
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| 468 | 468 | | |
|---|
| 469 | 469 | | July 1, 2011 |
|---|
| 470 | 470 | | |
|---|
| 471 | 471 | | New section |
|---|
| 472 | 472 | | |
|---|
| 473 | 473 | | Sec. 11 |
|---|
| 474 | 474 | | |
|---|
| 475 | 475 | | July 1, 2011 |
|---|
| 476 | 476 | | |
|---|
| 477 | 477 | | 19a-180(a) |
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| 478 | 478 | | |
|---|
| 479 | 479 | | Sec. 12 |
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| 480 | 480 | | |
|---|
| 481 | 481 | | July 1, 2011 |
|---|
| 482 | 482 | | |
|---|
| 483 | 483 | | 19a-175(11) |
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| 484 | 484 | | |
|---|
| 485 | 485 | | Sec. 13 |
|---|
| 486 | 486 | | |
|---|
| 487 | 487 | | July 1, 2011 |
|---|
| 488 | 488 | | |
|---|
| 489 | 489 | | 17b-28e |
|---|
| 490 | 490 | | |
|---|
| 491 | 491 | | Sec. 14 |
|---|
| 492 | 492 | | |
|---|
| 493 | 493 | | July 1, 2011 |
|---|
| 494 | 494 | | |
|---|
| 495 | 495 | | 17b-342(i)(1) and (2) |
|---|
| 496 | 496 | | |
|---|
| 497 | 497 | | Sec. 15 |
|---|
| 498 | 498 | | |
|---|
| 499 | 499 | | July 1, 2011 |
|---|
| 500 | 500 | | |
|---|
| 501 | 501 | | 19a-495a |
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| 502 | 502 | | |
|---|
| 503 | 503 | | Sec. 16 |
|---|
| 504 | 504 | | |
|---|
| 505 | 505 | | July 1, 2011 |
|---|
| 506 | 506 | | |
|---|
| 507 | 507 | | 17b-490 |
|---|
| 508 | 508 | | |
|---|
| 509 | 509 | | Sec. 17 |
|---|
| 510 | 510 | | |
|---|
| 511 | 511 | | July 1, 2011 |
|---|
| 512 | 512 | | |
|---|
| 513 | 513 | | 17b-492 |
|---|
| 514 | 514 | | |
|---|
| 515 | 515 | | Sec. 18 |
|---|
| 516 | 516 | | |
|---|
| 517 | 517 | | July 1, 2011 |
|---|
| 518 | 518 | | |
|---|
| 519 | 519 | | 17b-265f |
|---|
| 520 | 520 | | |
|---|
| 521 | 521 | | Sec. 19 |
|---|
| 522 | 522 | | |
|---|
| 523 | 523 | | July 1, 2011 |
|---|
| 524 | 524 | | |
|---|
| 525 | 525 | | 17b-340(g) |
|---|
| 526 | 526 | | |
|---|
| 527 | 527 | | Sec. 20 |
|---|
| 528 | 528 | | |
|---|
| 529 | 529 | | July 1, 2011 |
|---|
| 530 | 530 | | |
|---|
| 531 | 531 | | New section |
|---|
| 532 | 532 | | |
|---|
| 533 | 533 | | Sec. 21 |
|---|
| 534 | 534 | | |
|---|
| 535 | 535 | | July 1, 2011 |
|---|
| 536 | 536 | | |
|---|
| 537 | 537 | | 17b-265d(c) |
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| 538 | 538 | | |
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| 539 | 539 | | Sec. 22 |
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| 540 | 540 | | |
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| 541 | 541 | | July 1, 2011 |
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| 542 | 542 | | |
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| 543 | 543 | | 17b-260d |
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| 544 | 544 | | |
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| 545 | 545 | | Sec. 23 |
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| 546 | 546 | | |
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| 547 | 547 | | July 1, 2011 |
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| 548 | 548 | | |
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| 549 | 549 | | 17b-106(b) |
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| 550 | 550 | | |
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| 551 | 551 | | Sec. 24 |
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| 552 | 552 | | |
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| 553 | 553 | | July 1, 2011 |
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| 554 | 554 | | |
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| 555 | 555 | | 17b-278g(a) |
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| 556 | 556 | | |
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| 557 | 557 | | Sec. 25 |
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| 558 | 558 | | |
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| 559 | 559 | | July 1, 2011 |
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| 560 | 560 | | |
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| 561 | 561 | | 17b-372(e) |
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| 562 | 562 | | |
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| 563 | 563 | | Sec. 26 |
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| 564 | 564 | | |
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| 565 | 565 | | July 1, 2011 |
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| 566 | 566 | | |
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| 567 | 567 | | 17b-790a(b) |
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| 568 | 568 | | |
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| 569 | 569 | | Sec. 27 |
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| 570 | 570 | | |
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| 571 | 571 | | July 1, 2011 |
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| 572 | 572 | | |
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| 573 | 573 | | 17b-802 |
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| 574 | 574 | | |
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| 575 | 575 | | Sec. 28 |
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| 576 | 576 | | |
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| 577 | 577 | | July 1, 2011 |
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| 578 | 578 | | |
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| 579 | 579 | | 17b-749a |
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| 580 | 580 | | |
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| 581 | 581 | | Sec. 29 |
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| 582 | 582 | | |
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| 583 | 583 | | July 1, 2011 |
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| 584 | 584 | | |
|---|
| 585 | 585 | | 17b-749c(a) |
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| 586 | 586 | | |
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| 587 | 587 | | Sec. 30 |
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| 588 | 588 | | |
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| 589 | 589 | | July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 |
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| 590 | 590 | | |
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| 591 | 591 | | 12-263a |
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| 592 | 592 | | |
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| 593 | 593 | | Sec. 31 |
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| 594 | 594 | | |
|---|
| 595 | 595 | | July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 |
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| 596 | 596 | | |
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| 597 | 597 | | 12-263b |
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| 598 | 598 | | |
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| 599 | 599 | | Sec. 32 |
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| 600 | 600 | | |
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| 601 | 601 | | July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 |
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| 602 | 602 | | |
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| 603 | 603 | | 12-263c |
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| 604 | 604 | | |
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| 605 | 605 | | Sec. 33 |
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| 606 | 606 | | |
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| 607 | 607 | | July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 |
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| 608 | 608 | | |
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| 609 | 609 | | 12-263d |
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| 610 | 610 | | |
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| 611 | 611 | | Sec. 34 |
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| 612 | 612 | | |
|---|
| 613 | 613 | | July 1, 2011, and applicable to calendar quarters commencing on or after July 1, 2011 |
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| 614 | 614 | | |
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| 615 | 615 | | New section |
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| 616 | 616 | | |
|---|
| 617 | 617 | | Sec. 35 |
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| 618 | 618 | | |
|---|
| 619 | 619 | | July 1, 2011 |
|---|
| 620 | 620 | | |
|---|
| 621 | 621 | | 17b-321 |
|---|
| 622 | 622 | | |
|---|
| 623 | 623 | | Sec. 36 |
|---|
| 624 | 624 | | |
|---|
| 625 | 625 | | July 1, 2011 |
|---|
| 626 | 626 | | |
|---|
| 627 | 627 | | New section |
|---|
| 628 | 628 | | |
|---|
| 629 | 629 | | Sec. 37 |
|---|
| 630 | 630 | | |
|---|
| 631 | 631 | | July 1, 2011 |
|---|
| 632 | 632 | | |
|---|
| 633 | 633 | | New section |
|---|
| 634 | 634 | | |
|---|
| 635 | 635 | | Sec. 38 |
|---|
| 636 | 636 | | |
|---|
| 637 | 637 | | July 1, 2011 |
|---|
| 638 | 638 | | |
|---|
| 639 | 639 | | New section |
|---|
| 640 | 640 | | |
|---|
| 641 | 641 | | Sec. 39 |
|---|
| 642 | 642 | | |
|---|
| 643 | 643 | | July 1, 2011 |
|---|
| 644 | 644 | | |
|---|
| 645 | 645 | | New section |
|---|
| 646 | 646 | | |
|---|
| 647 | 647 | | Sec. 40 |
|---|
| 648 | 648 | | |
|---|
| 649 | 649 | | from passage |
|---|
| 650 | 650 | | |
|---|
| 651 | 651 | | 17b-261a |
|---|
| 652 | 652 | | |
|---|
| 653 | 653 | | Sec. 41 |
|---|
| 654 | 654 | | |
|---|
| 655 | 655 | | from passage |
|---|
| 656 | 656 | | |
|---|
| 657 | 657 | | 17b-28d |
|---|
| 658 | 658 | | |
|---|
| 659 | 659 | | Sec. 42 |
|---|
| 660 | 660 | | |
|---|
| 661 | 661 | | July 1, 2011 |
|---|
| 662 | 662 | | |
|---|
| 663 | 663 | | Repealer section |
|---|
| 664 | 664 | | |
|---|
| 665 | 665 | | Statement of Purpose: |
|---|
| 666 | 666 | | |
|---|
| 667 | 667 | | To implement the Governor's budget recommendations. |
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| 668 | 668 | | |
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| 669 | 669 | | [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.] |
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