Connecticut 2020 Regular Session

Connecticut Senate Bill SB00191 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
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3	3	LCO No. 1615 1 of 7
4	4
5	5	General Assembly Raised Bill No. 191
6	6	February Session, 2020
7	7	LCO No. 1615
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9	9
10	10	Referred to Committee on HUMAN SERVICES
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12	12
13	13	Introduced by:
14	14	(HS)
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19	19	AN ACT CONCERNING CH ANGES TO THE HUSKY B PROGRAM.
20	20	Be it enacted by the Senate and House of Representatives in General
21	21	Assembly convened:
22	22
23	23	Section 1. Subsection (a) of section 17b-295 of the general statutes is 1
24	24	repealed and the following is substituted in lieu thereof (Effective from 2
25	25	passage): 3
26	26	(a) The commissioner shall impose cost-sharing requirements, 4
27	27	including the payment of a premium or copayment, in connection with 5
28	28	services provided under HUSKY B, to the extent permitted by federal 6
29	29	law. Copayments under HUSKY B shall [be the same as] not exceed 7
30	30	those in effect for active state employees enrolled in a point-of-8
31	31	enrollment health care plan, provided the household's annual combined 9
32	32	premiums and copayments do not exceed the maximum annual 10
33	33	aggregate cost-sharing requirement. The cost-sharing requirements 11
34	34	imposed by the commissioner shall be in accordance with the following 12
35	35	limitations: 13
36	36	(1) The commissioner may increase the maximum annual aggregate 14
37	37	cost-sharing requirements, provided such cost-sharing requirements 15 Raised Bill No. 191
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39	39
40	40
41	41	LCO No. 1615 2 of 7
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43	43	shall not exceed five per cent of the household's gross annual income. 16
44	44	(2) In accordance with federal law, the commissioner may impose a 17
45	45	premium requirement on households whose income exceeds two 18
46	46	hundred forty-nine per cent of the federal poverty level as a component 19
47	47	of the household's cost-sharing responsibility; [and, for the fiscal years 20
48	48	ending June 30, 2012, to June 30, 2016, inclusive, may annually increase 21
49	49	the premium requirement based on the percentage increase in the 22
50	50	Consumer Price Index for medical care services;] and 23
51	51	(3) The commissioner shall monitor copayments and premiums 24
52	52	under the provisions of subdivision (1) of this subsection. 25
53	53	Sec. 2. Section 17b-266 of the general statutes is repealed and the 26
54	54	following is substituted in lieu thereof (Effective from passage): 27
55	55	(a) The Commissioner of Social Services may, when the commissioner 28
56	56	finds it to be in the public interest, fund part or all of the cost of benefits 29
57	57	to any recipient under sections 17b-260 to 17b-262, inclusive, 17b-264 to 30
58	58	17b-285, inclusive, 17b-357 to 17b-361, inclusive, 17b-290, as amended 31
59	59	by this act, 17b-292, [17b-294a,] 17b-295, as amended by this act, 17b-32
60	60	297a, 17b-297b and 17b-300 through the purchase of insurance from any 33
61	61	organization authorized to do a health insurance business in this state 34
62	62	or from any organization specified in subsection (b) of this section. 35
63	63	(b) The Commissioner of Social Services may require recipients of 36
64	64	Medicaid or other public assistance to receive medical care on a 37
65	65	prepayment or per capita basis, in accordance with federal law and 38
66	66	regulations, if such prepayment is anticipated to result in lower medical 39
67	67	assistance costs to the state. The commissioner may enter into contracts 40
68	68	for the provision of comprehensive health care on a prepayment or per 41
69	69	capita basis in accordance with federal law and regulations, with the 42
70	70	following: (1) A health care center subject to the provisions of chapter 43
71	71	698a; (2) a consortium of federally qualified community health centers 44
72	72	and other community-based providers of health services which are 45
73	73	funded by the state; (3) other consortia of providers of health care 46
74	74	services established for the purposes of this subsection; or (4) an 47 Raised Bill No. 191
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78	78	LCO No. 1615 3 of 7
79	79
80	80	integrated service network providing care management and 48
81	81	comprehensive health care on a prepayment or per capita basis to 49
82	82	elderly and disabled recipients of Medicaid who may also be eligible for 50
83	83	Medicare. 51
84	84	(c) Providers of comprehensive health care services as described in 52
85	85	subdivisions (2), (3) and (4) of subsection (b) of this section shall not be 53
86	86	subject to the provisions of chapter 698a or, in the case of an integrated 54
87	87	service network, sections 17b-239 to 17b-245, inclusive, 17b-281, 17b-340, 55
88	88	17b-342 and 17b-343. Any such provider shall be certified by the 56
89	89	Commissioner of Social Services in accordance with criteria established 57
90	90	by the commissioner, including, but not limited to, minimum reserve 58
91	91	fund requirements. 59
92	92	(d) The commissioner shall pay all capitation claims which would 60
93	93	otherwise be reimbursed to the health plans described in subsection (b) 61
94	94	of this section in May, 2010, no later than June 30, 2010. Each subsequent 62
95	95	payment made by the commissioner to such health plans for capitation 63
96	96	claims due shall be made in the second month following the month to 64
97	97	which the capitation applies. 65
98	98	(e) On or after May 1, 2000, the payment to the Commissioner of 66
99	99	Social Services of (1) any monetary sanction imposed by the 67
100	100	commissioner on a managed care organization under the provisions of 68
101	101	a contract between the commissioner and such organization entered 69
102	102	into pursuant to this section or sections 17b-290, as amended by this act, 70
103	103	17b-292, [17b-294a,] 17b-295, as amended by this act, 17b-297a, 17b-297b 71
104	104	and 17b-300, or (2) any sum agreed upon by the commissioner and such 72
105	105	an organization as settlement of a claim brought by the commissioner 73
106	106	or the state against such an organization for failure to comply with the 74
107	107	terms of a contract with the commissioner or fraud affecting the 75
108	108	Department of Social Services shall be deposited in an account 76
109	109	designated for use by the department for expenditures for children's 77
110	110	health programs and services. 78
111	111	Sec. 3. Section 17b-290 of the general statutes is repealed and the 79 Raised Bill No. 191
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114	114
115	115	LCO No. 1615 4 of 7
116	116
117	117	following is substituted in lieu thereof (Effective from passage): 80
118	118	As used in this section and sections 17b-292, [17b-294a,] 17b-295, as 81
119	119	amended by this act, 17b-297a, 17b-297b and 17b-300: 82
120	120	(1) "Applicant" means an individual over the age of eighteen years 83
121	121	who is a natural or adoptive parent, a legal guardian, a caretaker 84
122	122	relative, foster parent or stepparent with whom the child resides and 85
123	123	shall include a child who is eighteen years of age or emancipated in 86
124	124	accordance with the provisions of sections 46b-150 to 46b-150e, 87
125	125	inclusive, and who is applying on his own behalf or on behalf of a minor 88
126	126	dependent for coverage under such plan; 89
127	127	(2) "Child" means an individual under nineteen years of age; 90
128	128	(3) "Coinsurance" means the sharing of health care expenses by the 91
129	129	insured and an insurer in a specified ratio; 92
130	130	(4) "Commissioner" means the Commissioner of Social Services; 93
131	131	(5) "Copayment" means a payment made on behalf of a member for a 94
132	132	specified service under HUSKY B; 95
133	133	(6) "Cost sharing" means arrangements made on behalf of a member 96
134	134	whereby an applicant pays a portion of the cost of health services, 97
135	135	sharing costs with the state and includes copayments, premiums, 98
136	136	deductibles and coinsurance; 99
137	137	(7) "Deductible" means the amount of out-of-pocket expenses that 100
138	138	would be paid for health services on behalf of a member before 101
139	139	becoming payable by the insurer; 102
140	140	(8) "Department" means the Department of Social Services; 103
141	141	(9) "Durable medical equipment" means equipment that meets all of 104
142	142	the following requirements: 105
143	143	(A) Can withstand repeated use; 106 Raised Bill No. 191
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146	146
147	147	LCO No. 1615 5 of 7
148	148
149	149	(B) Is primarily and customarily used to serve a medical purpose; 107
150	150	(C) Generally is not useful to a person in the absence of an illness or 108
151	151	injury; and 109
152	152	(D) Is nondisposable; 110
153	153	(10) "Eligible beneficiary" means a child who meets the requirements 111
154	154	in section 17b-292, and the requirements specified in Section 112
155	155	2110(b)(2)(B) of the Social Security Act as amended by Section 113
156	156	10203(b)(2)(D) of the Affordable Care Act; 114
157	157	(11) "Household" has the same meaning as provided in 42 CFR 115
158	158	435.603; 116
159	159	(12) "Household income" has the same meaning as provided in 42 117
160	160	CFR 435.603; 118
161	161	(13) "HUSKY A" means Medicaid provided to children, caretaker 119
162	162	relatives and pregnant and postpartum women pursuant to section 17b-120
163	163	261 or 17b-277; 121
164	164	(14) "HUSKY B" means the health coverage for children established 122
165	165	pursuant to the provisions of sections 17b-290, as amended by this act, 123
166	166	17b-292, [17b-294a,] 17b-295, as amended by this act, 17b-297a, 17b-297b 124
167	167	and 17b-300; 125
168	168	(15) "HUSKY C" means Medicaid provided to individuals who are 126
169	169	sixty-five years of age or older or who are blind or have a disability; 127
170	170	(16) "HUSKY D" or "Medicaid Coverage for the Lowest Income 128
171	171	Populations program" means Medicaid provided to nonpregnant low-129
172	172	income adults who are age eighteen to sixty-four, as authorized 130
173	173	pursuant to section 17b-8a; 131
174	174	(17) "HUSKY Health" means the combined HUSKY A, HUSKY B, 132
175	175	HUSKY C and HUSKY D programs, that provide medical coverage to 133
176	176	eligible children, parents, relative caregivers, persons age sixty-five or 134 Raised Bill No. 191
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178	178
179	179
180	180	LCO No. 1615 6 of 7
181	181
182	182	older, individuals with disabilities, low-income adults, and pregnant 135
183	183	women; 136
184	184	[(18) "HUSKY Plus" means the supplemental health program 137
185	185	established pursuant to section 17b-294a for medically eligible members 138
186	186	of HUSKY B whose medical needs cannot be accommodated within the 139
187	187	basic benefit package offered to members. HUSKY Plus shall 140
188	188	supplement coverage for those medically eligible members with 141
189	189	intensive physical health needs;] 142
190	190	[(19)] (18) "Member" means an eligible beneficiary who receives 143
191	191	services under HUSKY A, B, C or D; 144
192	192	[(20)] (19) "Parent" means a natural parent, stepparent, adoptive 145
193	193	parent, guardian or custodian of a child; 146
194	194	[(21)] (20) "Premium" means any required payment made by an 147
195	195	individual to offset the cost under HUSKY B; 148
196	196	[(22)] (21) "Qualified entity" means any entity: (A) Eligible for 149
197	197	payments under a state plan approved under Medicaid and which 150
198	198	provides medical services under HUSKY A, or (B) that is a qualified 151
199	199	entity, as defined in 42 USC 1396r-1a, as amended by Section 708 of 152
200	200	Public Law 106-554, and that is determined by the commissioner to be 153
201	201	capable of making the determination of eligibility. The commissioner 154
202	202	shall provide qualified entities with such forms or information on filing 155
203	203	an application electronically as is necessary for an application to be 156
204	204	made on behalf of a child under HUSKY A and information on how to 157
205	205	assist parents, guardians and other persons in completing and filing 158
206	206	such forms or electronic application; and 159
207	207	[(23)] (22) "WIC" means the federal Special Supplemental Food 160
208	208	Program for Women, Infants and Children administered by the 161
209	209	Department of Public Health pursuant to section 19a-59c. 162
210	210	Sec. 4. Section 17b-304 of the general statutes is repealed and the 163
211	211	following is substituted in lieu thereof (Effective from passage): 164 Raised Bill No. 191
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214	214
215	215	LCO No. 1615 7 of 7
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217	217	The Commissioner of Social Services shall implement the policies and 165
218	218	procedures necessary to carry out the provisions of sections 17b-292, 166
219	219	[17b-294a,] 17b-295, as amended by this act, 17b-297a, 17b-297b and 17b-167
220	220	300 while in the process of adopting such policies and procedures in 168
221	221	regulation form, provided notice of intent to adopt the regulations is 169
222	222	[published] posted on the Department of Social Services' Internet web 170
223	223	site and the eRegulations System not later than twenty days after 171
224	224	implementation. Such policies and procedures shall be valid until the 172
225	225	time final regulations are effective. 173
226	226	Sec. 5. Section 17b-294a of the general statutes is repealed. (Effective 174
227	227	from passage) 175
228	228	This act shall take effect as follows and shall amend the following
229	229	sections:
230	230
231	231	Section 1 from passage 17b-295(a)
232	232	Sec. 2 from passage 17b-266
233	233	Sec. 3 from passage 17b-290
234	234	Sec. 4 from passage 17b-304
235	235	Sec. 5 from passage Repealer section
236	236
237	237	Statement of Purpose:
238	238	To cap copayments to the HUSKY B health program and repeal a
239	239	program offering intensive services that are offered under a related
240	240	program.
241	241	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
242	242	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
243	243	underlined.]
244	244