General Assembly Raised Bill No. 135
February Session, 2016 LCO No. 1473
*01473_______HS_*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
General Assembly
Raised Bill No. 135
February Session, 2016
LCO No. 1473
*01473_______HS_*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING REVISIONS TO HUSKY PLUS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 17b-294a of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(a) The commissioner shall, within available appropriations, establish a supplemental health program to be known as HUSKY Plus for [members of the subsidized portions of] HUSKY B members whose medical needs cannot be accommodated within the basic benefit package offered to members. The HUSKY Plus program shall supplement coverage for those medically eligible members with intensive physical health needs.
(b) Within available appropriations, the commissioner shall contract with one or more entities to (1) administer and operate the HUSKY Plus program, [Such entities shall be the same entities that the Department of Public Health contracts with to administer and operate the program under Title V of the Social Security Act. The advisory committee established by the Department of Public Health for Title V of the Social Security Act shall be the steering committee for such program, except that such committee shall include representatives of the Departments of Social Services and Children and Families] and (2) conduct an external quality review of the HUSKY Plus program.
(c) [The acuity standards or diagnostic eligibility criteria, or both, the service benefits package and the provider network for the HUSKY Plus program shall be consistent with that of Title V of the Social Security Act. Such] The service benefit package shall be supplemental to HUSKY B services and shall include powered wheelchairs. If a provider is not enrolled in the medical assistance program, the provider shall accept the medical assistance program rates as payment in full and such other conditions as the commissioner may specify.
(d) The commissioner shall adopt regulations, in accordance with chapter 54, to (1) establish criteria and specify services for the HUSKY Plus program, and (2) establish a procedure for the appeal of a denial of coverage under the HUSKY Plus program. [Such regulations shall provide that (1) an appeal of a denial of coverage for a medically eligible member shall be taken to the steering committee, and (2) a medically eligible member may appeal the decision of any such steering committee to the commissioner] Such regulations shall state that the HUSKY Plus program shall give priority in such program to members with household incomes at or below two hundred forty-nine per cent of the federal poverty level.
[(e) The commissioner shall contract for an external quality review of the HUSKY Plus program.]
[(f)] (e) On and after the date on which any medically eligible member begins receiving benefits under the HUSKY Plus program, such member shall not be eligible for services under Title V of the Social Security Act, with the exception of respite care services.
[(g) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to establish criteria and specify services for the HUSKY Plus program. Such regulations shall state that the HUSKY Plus program shall give priority in such program to members with household incomes at or below two hundred forty-nine per cent of the federal poverty level.]
[(h)] (f) As used in this section, "medically eligible member" means any member with intensive physical health needs [who meets the acuity standards or diagnostic eligibility criteria adopted by the commissioner regarding the acuity, diagnosis, functional impairment and intensive service needs of the member] whose medical needs cannot be met within the HUSKY B benefits offered to members.
This act shall take effect as follows and shall amend the following sections:
Section 1 from passage 17b-294a
This act shall take effect as follows and shall amend the following sections:
Section 1
from passage
17b-294a
Statement of Purpose:
To update and clarify provisions concerning program participants, administration, the appeal process, external review, provider rates and services.
[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.]