LCO No. 4635 1 of 3
General Assembly Raised Bill No. 895
January Session, 2019
LCO No. 4635
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING ME DICAID COVERAGE OF IN-HOME
COUNSELING PROVIDED BY A HOME HEALTH CAR E AGENCY.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (a) of section 17b-242 of the general statutes is 1
repealed and the following is substituted in lieu thereof (Effective July 2
1, 2019): 3
(a) The Department of Social Services shall determine the rates to be 4
paid to home health care agencies and homemaker-home health aide 5
agencies by the state or any town in the state for persons aided or 6
cared for by the state or any such town. [For the period from February 7
1, 1991, to January 31, 1992, inclusive, payment for each service to the 8
state shall be based upon the rate for such service as determined by the 9
Office of Health Care Access, except that for those providers whose 10
Medicaid rates for the year ending January 31, 1991, exceed the median 11
rate, no increase shall be allowed. For those providers whose rates for 12
the year ending January 31, 1991, are below the median rate, increases 13
shall not exceed the lower of the prior rate increased by the most 14
recent annual increase in the consumer price index for urban 15 Raised Bill No. 895
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consumers or the median rate. In no case shall any such rate exceed the 16
eightieth percentile of rates in effect January 31, 1991, nor shall any rate 17
exceed the charge to the general public for similar services. Rates 18
effective February 1, 1992, shall be based upon rates as determined by 19
the Office of Health Care Access, except that increases shall not exceed 20
the prior year's rate increased by the most recent annual increase in the 21
consumer price index for urban consumers and rates effective 22
February 1, 1992, shall remain in effect through June 30, 1993. Rates 23
effective July 1, 1993, shall be based upon rates as determined by the 24
Office of Health Care Access except if the Medicaid rates for any 25
service for the period ending June 30, 1993, exceed the median rate for 26
such service, the increase effective July 1, 1993, shall not exceed one 27
per cent. If the Medicaid rate for any service for the period ending June 28
30, 1993, is below the median rate, the increase effective July 1, 1993, 29
shall not exceed the lower of the prior rate increased by one and one-30
half times the most recent annual increase in the consumer price index 31
for urban consumers or the median rate plus one per cent.] The 32
Commissioner of Social Services shall establish a fee schedule for home 33
health services to be effective on and after July 1, 1994. The 34
commissioner may annually modify such fee schedule if such 35
modification is needed to ensure that the conversion to an 36
administrative services organization is cost neutral to home health care 37
agencies and homemaker-home health aide agencies in the aggregate 38
and ensures patient access. Utilization may be a factor in determining 39
cost neutrality. The commissioner shall increase the fee schedule for 40
home health services provided under the Connecticut home-care 41
program for the elderly established under section 17b-342, effective 42
July 1, 2000, by two per cent over the fee schedule for home health 43
services for the previous year. The commissioner may increase any fee 44
payable to a home health care agency or homemaker-home health aide 45
agency upon the application of such an agency evidencing 46
extraordinary costs related to (1) serving persons with AIDS; (2) high-47
risk maternal and child health care; (3) escort services; or (4) extended 48
hour services. In no case shall any rate or fee exceed the charge to the 49
general public for similar services. The commissioner shall include in 50 Raised Bill No. 895
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the fee schedule rates to be paid under the medical assistance program 51
for behavioral health counseling provided to a medical assistance 52
beneficiary in his or her home by a social worker employed by a home 53
health care agency who is licensed pursuant to chapter 383b. A home 54
health care agency or homemaker-home health aide agency which, due 55
to any material change in circumstances, is aggrieved by a rate 56
determined pursuant to this subsection may, within ten days of receipt 57
of written notice of such rate from the Commissioner of Social Services, 58
request in writing a hearing on all items of aggrievement. The 59
commissioner shall, upon the receipt of all documentation necessary to 60
evaluate the request, determine whether there has been such a change 61
in circumstances and shall conduct a hearing if appropriate. The 62
Commissioner of Social Services shall adopt regulations, in accordance 63
with chapter 54, to implement the provisions of this subsection. The 64
commissioner may implement policies and procedures to carry out the 65
provisions of this subsection while in the process of adopting 66
regulations, provided notice of intent to adopt the regulations is 67
[published in the Connecticut Law Journal not later than twenty days 68
after the date of] posted on the eRegulations System prior to the date 69
of adopting the regulations and implementing the policies and 70
procedures. Such policies and procedures shall be valid for not longer 71
than nine months. 72
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2019 17b-242(a)
Statement of Purpose:
To provide Medicaid coverage for behavioral counseling provided to
Medicaid beneficiaries in their homes by licensed social workers
employed by home health care agencies.
[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.]