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General Assembly Raised Bill No. 764
January Session, 2021
LCO No. 2589
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING ME DICAID PROVIDERS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 17b-28e of the general statutes is amended by 1
adding subsection (d) as follows (Effective from passage): 2
(NEW) (d) Not later than October 1, 2021, the Commissioner of Social 3
Services shall amend the Medicaid state plan to include services 4
provided by acupuncturists licensed pursuant to section 20-206bb and 5
chiropractors licensed pursuant to section 20-27 as optional services 6
under the Medicaid program. 7
Sec. 2. Section 17b-280c of the general statutes is repealed and the 8
following is substituted in lieu thereof (Effective July 1, 2021): 9
(a) For purposes of this section: (1) "Methadone maintenance" means 10
a chemical maintenance program under which an addiction to one drug, 11
including, but not limited to, heroin, is treated with the drug methadone 12
in a weekly program that includes on and off-site methadone 13
administration, drug testing and counseling; and (2) "chemical 14
maintenance provider" means a provider certified and licensed by the 15 Raised Bill No. 764
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federal Substance Abuse and Mental Health Services Administration 16
and the state Department of Public Health who meets all federal and 17
state requirements, including, but not limited to, requirements specific 18
to the provision of chemical maintenance services. 19
(b) The Commissioner of Social Services shall amend the Medicaid 20
state plan to provide a minimum weekly reimbursement rate of eighty-21
eight dollars and fifty-two cents to a chemical maintenance provider for 22
methadone maintenance treatment of a Medicaid beneficiary, provided 23
no such provider receiving a higher rate shall have such rate reduced to 24
the minimum as a result of the implementation of a new minimum 25
reimbursement rate. 26
[(c) Notwithstanding subsection (b) of this section, on or after July 1, 27
2020, any reimbursement to a chemical maintenance provider for 28
methadone maintenance treatment shall be contingent upon meeting 29
certain performance measures as determined by the commissioner. Such 30
performance measures shall be developed in consultation with the 31
Department of Mental Health and Addiction Services and chemical 32
maintenance providers. Initial performance measures shall be 33
developed by September 30, 2019, including the means by which such 34
measures shall be evaluated. The initial evaluation period shall be based 35
on the claims data for the quarter ending March 31, 2020. The 36
performance measures and thresholds may be adjusted after the initial 37
evaluation period. Failure to meet department-identified standards on 38
performance measures shall result in a rate reduction of (1) up to five 39
per cent for the quarters ending September 30, 2020, and December 31, 40
2020, and (2) up to ten per cent beginning January 1, 2021. No provider 41
shall receive a rate decrease under this subsection that is more than a ten 42
per cent decrease annually.] 43
[(d)] (c) The Commissioner of Social Services, pursuant to section 17b-44
10, may implement policies and procedures to administer the provisions 45
of this section while in the process of adopting such policies and 46
procedures in regulation form, provided the commissioner [prints] 47
posts notice of the intent to adopt the regulations on the department's 48 Raised Bill No. 764
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Internet web site and the eRegulations System not later than twenty 49
days after the date of implementation. Such policies and procedures 50
shall be valid until the time final regulations are adopted. 51
Sec. 3. (NEW) (Effective from passage) The Commissioner of Social 52
Services shall adjust rates of reimbursement under the Medicaid 53
program so that (1) a nurse-midwife licensed pursuant to chapter 377 of 54
the general statutes receives the same rate as an obstetrician-55
gynecologist licensed pursuant to chapter 370 of the general statutes for 56
performing the same medical service or procedure, and (2) a podiatrist 57
licensed pursuant to chapter 375 of the general statutes receives the 58
same rate as a physician licensed pursuant to chapter 370 of the general 59
statutes for performing the same medical service or procedure. The 60
commissioner shall seek federal approval to amend the Medicaid state 61
plan, if necessary, to adjust rates of reimbursement in accordance with 62
this section. 63
Sec. 4. (NEW) (Effective July 1, 2021) The Commissioner of Social 64
Services shall amend the Medicaid state plan to integrate services 65
provided by peer support specialists into the medical assistance 66
program and provide Medicaid reimbursement for such services. For 67
purposes of this section, "peer support services" means a recovery-68
focused behavioral health service that allows an individual the 69
opportunity to learn to manage his or her recovery with help from a peer 70
support specialist who may have experience recovering from mental 71
illness or substance use disorder.72
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 17b-28e
Sec. 2 July 1, 2021 17b-280c
Sec. 3 from passage New section
Sec. 4 July 1, 2021 New section
Statement of Purpose:
To add acupuncture and chiropractor services to those covered under
Medicaid, adjust the Medicaid payment methodology for methadone Raised Bill No. 764
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maintenance providers, achieve Medicaid payment parity for nurse-
midwives and podiatrists performing the same services as physicians,
and provide Medicaid reimbursement to peer support specialists.
[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.]