| 14 | | - | Section 1. (NEW) (Effective July 1, 2019) (a) The Commissioner of |
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| 15 | | - | Social Services, to the extent permissible under federal law, shall |
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| 16 | | - | provide Medicaid coverage for medically necessary pasteurized donor |
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| 17 | | - | breast milk provided: (1) A physician, physician's assistant or |
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| 18 | | - | advanced practice registered nurse licensed pursuant to chapter 370 or |
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| 19 | | - | 378 of the general statutes signs an order stating that such milk is |
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| 20 | | - | medically necessary for an infant Medicaid beneficiary in accordance |
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| 21 | | - | with section 17b-259b of the general statutes; and (2) (A) the infant is |
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| 22 | | - | medically or physically unable to receive maternal breast milk or |
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| 23 | | - | participate in breastfeeding, or (B) the infant's mother is medically or |
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| 24 | | - | physically unable to produce maternal breast milk in sufficient |
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| 25 | | - | quantities. |
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| 26 | | - | (b) The commissioner shall adopt or amend regulations to |
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| 27 | | - | implement the provisions of this section, including, but not limited to, |
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| 28 | | - | establishing infant birth weight and health conditions that may make |
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| 29 | | - | the provision of pasteurized donor breast milk medically necessary |
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| 30 | | - | and time limits for Medicaid coverage of pasteurized donor breast |
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| 31 | | - | milk. The commissioner may adopt a policy or procedure to Substitute House Bill No. 7165 |
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| 19 | + | Section 1. (NEW) (Effective July 1, 2019) (a) The Commissioner of 1 |
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| 20 | + | Social Services shall provide Medicaid reimbursement for pasteurized 2 |
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| 21 | + | donor breast milk, provided (1) a health care professional licensed 3 |
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| 22 | + | pursuant to chapter 370 of the general statutes signs a medical order 4 |
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| 23 | + | that the donor breast milk is medically necessary for an infant 5 |
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| 24 | + | Medicaid beneficiary in accordance with section 17b-259b of the 6 |
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| 25 | + | general statutes, (2) the donor breast milk is provided on an inpatient 7 |
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| 26 | + | basis at a hospital, and (3) (A) the infant who receives the donor breast 8 |
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| 27 | + | milk is medically or physically unable to receive maternal breast milk 9 |
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| 28 | + | or participate in breast feeding, or (B) the infant's mother is medically 10 |
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| 29 | + | or physically unable to produce maternal breast milk in sufficient 11 |
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| 30 | + | quantities, or is unable to participate in breast feeding despite optimal 12 |
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| 31 | + | lactation support. 13 |
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| 32 | + | (b) The commissioner shall seek federal approval of a Medicaid state 14 |
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| 33 | + | plan amendment or Medicaid waiver if necessary to implement the 15 |
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| 34 | + | provisions of this section. Any submission of a Medicaid state plan 16 |
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| 35 | + | amendment or Medicaid waiver shall be in accordance with the 17 |
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| 36 | + | provisions of section 17b-8 of the general statutes. 18 Substitute Bill No. 7165 |
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| 35 | | - | implement the provisions of this section while in the process of |
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| 36 | | - | adopting regulations, provided such policy or procedure is posted on |
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| 37 | | - | the Internet web site of the Department of Social Services and on the |
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| 38 | | - | eRegulations System prior to adoption of the policy. |
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| 39 | | - | (c) The commissioner, if necessary, shall seek federal approval for a |
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| 40 | | - | Medicaid waiver or state plan amendm ent to implement the |
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| 41 | | - | provisions of this section in accordance with the provisions of section |
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| 42 | | - | 17b-8 of the general statutes. |
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| 39 | + | LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-07165- |
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| 40 | + | R01-HB.docx } |
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| 41 | + | 2 of 2 |
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| 42 | + | |
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| 43 | + | (c) The commissioner shall adopt regulations, in accordance with 19 |
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| 44 | + | the provisions of chapter 54 of the general statutes, to implement the 20 |
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| 45 | + | provisions of this section, including, but not limited to, establishing 21 |
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| 46 | + | infant health conditions that qualify for medically necessary donor 22 |
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| 47 | + | breast milk. The commissioner may adopt policies or procedures to 23 |
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| 48 | + | implement the provisions of this section while in the process of 24 |
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| 49 | + | adopting regulations provided such policies or procedures are posted 25 |
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| 50 | + | on the Internet web site of the Department of Social Services and on 26 |
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| 51 | + | the eRegulations System prior to the adoption of such policies or 27 |
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| 52 | + | procedures. 28 |
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| 53 | + | This act shall take effect as follows and shall amend the following |
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| 54 | + | sections: |
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| 55 | + | |
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| 56 | + | Section 1 July 1, 2019 New section |
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| 57 | + | |
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| 58 | + | Statement of Legislative Commissioners: |
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| 59 | + | In Section 1(a), "Medicaid beneficiary" was added after "infant" for |
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| 60 | + | clarity. |
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| 61 | + | |
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| 62 | + | HS Joint Favorable Subst. |
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