| 16 | | - | Section 1. (NEW) (Effective from passage) (a) For purposes of this section, (1) "long-acting reversible contraceptive" means a birth control method that may be effective for years, is reversible and includes, but is not limited to, intrauterine devices and contraceptive implants, and (2) "federally qualified health center" means a facility that serves a medically underserved area or population, provides family planning or obstetric services and qualifies for funding under Section 330 of the Public Health Service Act, 42 USC 254b. |
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| 28 | + | Section 1. (Effective July 1, 2017) (a) For purposes of this section, "long-acting reversible contraceptive" means a birth control method that may be effective for years, is reversible and includes, but is not limited to, intrauterine devices and implants. |
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| 18 | | - | (b) The Commissioner of Social Services shall seek federal approval for an amendment to the Medicaid state plan to provide a separate rate of Medicaid reimbursement to a federally qualified health center for the actual acquisition cost of a long-acting reversible contraceptive provided at the request of a Medicaid recipient. The rate of reimbursement for a long-acting reversible contraceptive shall be in addition to reimbursement to the federally qualified health center for the Medicaid recipient's visit with the health care provider who provides the contraceptive. |
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| 30 | + | (b) The Commissioner of Social Services shall establish a one-year pilot program in Hartford and New Haven to promote the use of long-acting reversible contraceptives among not more than one thousand primarily adolescent Medicaid recipients to deter the rate of unwanted pregnancies and associated costs. |
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| 31 | + | |
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| 32 | + | (c) The commissioner shall reallocate not more than eight hundred thousand dollars in any Medicaid funding used for family planning to fund the pilot program and shall develop a Medicaid reimbursement system that encourages hospitals, pharmacists and other health care providers to participate in the program. Such system may include, but is not limited to: (1) Separate, additional Medicaid reimbursement for the provision of long-acting reversible contraceptives in addition to an obstetric fee when such contraceptives are provided immediately after a participating Medicaid recipient gives birth in a hospital; (2) a higher, separate rate of Medicaid reimbursement for provision of such contraceptive during an outpatient visit to a participating provider; (3) direct reimbursement with a dispensing fee add-on to pharmacies that provide such contraceptives to health care providers for participating Medicaid recipients; and (4) waiving preauthorization protocols for the provision of such contraceptives to participating Medicaid recipients. |
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| 33 | + | |
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| 34 | + | (d) As part of the pilot program, the commissioner shall provide: (1) Training for providers and staff regarding the provision of long-acting reversible contraceptives, including, but not limited to, counseling strategies and management of any side effects; (2) technical assistance regarding issues such as proper coding and billing procedures to ensure timely Medicaid reimbursement; and (3) marketing and outreach regarding the availability and advantages of such contraceptives among other currently available contraceptive services. |
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| 35 | + | |
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| 36 | + | (e) Not later than October 1, 2018, the commissioner shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, on the pilot program to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies, human services and public health. The report shall include, but need not be limited to: (1) Data on any reduction in unintended pregnancies and subsequent births, especially among adolescents, in Hartford and New Haven during the pilot program; (2) the number and location of family planning providers, obstetricians, hospitals and pharmacists that participated in the pilot program; (3) the average cost per participating Medicaid recipient; (4) estimated savings in Medicaid dollars related to any reduction in pregnancies related to the pilot program; and (5) any obstacles to successful outcomes of the pilot program. |
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| 37 | + | |
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| 38 | + | (f) The commissioner may seek federal and state grants to support the pilot program and any technical assistance provided by the federal Centers for Medicare and Medicaid Services for programs encouraging the use of long-acting reversible contraceptives among Medicaid recipients. |
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