Senate Bill No. 909
Public Act No. 21-123
AN ACT CONCERNING CHANGES TO THE HUSKY B PROGRAM.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (a) of section 17b-295 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(a) The commissioner shall impose cost-sharing requirements,
including the payment of a premium or copayment, in connection with
services provided under HUSKY B, to the extent permitted by federal
law. Copayments under HUSKY B shall [be the same as] not exceed
those in effect for active state employees enrolled in a point-of-
enrollment health care plan, provided the household's annual combined
premiums and copayments do not exceed the maximum annual
aggregate cost-sharing requirement. The cost-sharing requirements
imposed by the commissioner shall be in accordance with the following
limitations:
(1) The commissioner may increase the maximum annual aggregate
cost-sharing requirements, provided such cost-sharing requirements
shall not exceed five per cent of the household's gross annual income.
(2) In accordance with federal law, the commissioner may impose a Senate Bill No. 909
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premium requirement on households whose income exceeds two
hundred forty-nine per cent of the federal poverty level as a component
of the household's cost-sharing responsibility and, for the fiscal years
ending June 30, 2012, to June 30, 2016, inclusive, may annually increase
the premium requirement based on the percentage increase in the
Consumer Price Index for medical care services; and
(3) The commissioner shall monitor copayments and premiums
under the provisions of subdivision (1) of this subsection.
Sec. 2. Section 17b-266 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) The Commissioner of Social Services may, when the commissioner
finds it to be in the public interest, fund part or all of the cost of benefits
to any recipient under sections 17b-260 to 17b-262, inclusive, 17b-264 to
17b-285, inclusive, 17b-357 to 17b-361, inclusive, 17b-290, as amended
by this act, 17b-292, [17b-294a,] 17b-295, as amended by this act, 17b-
297a, 17b-297b and 17b-300 through the purchase of insurance from any
organization authorized to do a health insurance business in this state
or from any organization specified in subsection (b) of this section.
(b) The Commissioner of Social Services may require recipients of
Medicaid or other public assistance to receive medical care on a
prepayment or per capita basis, in accordance with federal law and
regulations, if such prepayment is anticipated to result in lower medical
assistance costs to the state. The commissioner may enter into contracts
for the provision of comprehensive health care on a prepayment or per
capita basis in accordance with federal law and regulations, with the
following: (1) A health care center subject to the provisions of chapter
698a; (2) a consortium of federally qualified community health centers
and other community-based providers of health services which are
funded by the state; (3) other consortia of providers of health care
services established for the purposes of this subsection; or (4) an Senate Bill No. 909
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integrated service network providing care management and
comprehensive health care on a prepayment or per capita basis to
elderly and disabled recipients of Medicaid who may also be eligible for
Medicare.
(c) Providers of comprehensive health care services as described in
subdivisions (2), (3) and (4) of subsection (b) of this section shall not be
subject to the provisions of chapter 698a or, in the case of an integrated
service network, sections 17b-239 to 17b-245, inclusive, 17b-281, 17b-340,
17b-342 and 17b-343. Any such provider shall be certified by the
Commissioner of Social Services in accordance with criteria established
by the commissioner, including, but not limited to, minimum reserve
fund requirements.
(d) The commissioner shall pay all capitation claims which would
otherwise be reimbursed to the health plans described in subsection (b)
of this section in May, 2010, no later than June 30, 2010. Each subsequent
payment made by the commissioner to such health plans for capitation
claims due shall be made in the second month following the month to
which the capitation applies.
(e) On or after May 1, 2000, the payment to the Commissioner of
Social Services of (1) any monetary sanction imposed by the
commissioner on a managed care organization under the provisions of
a contract between the commissioner and such organization entered
into pursuant to this section or sections 17b-290, as amended by this act,
17b-292, [17b-294a,] 17b-295, 17b-297a, 17b-297b and 17b-300, or (2) any
sum agreed upon by the commissioner and such an organization as
settlement of a claim brought by the commissioner or the state against
such an organization for failure to comply with the terms of a contract
with the commissioner or fraud affecting the Department of Social
Services shall be deposited in an account designated for use by the
department for expenditures for children's health programs and
services. Senate Bill No. 909
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Sec. 3. Section 17b-290 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
As used in this section and sections 17b-292, [17b-294a,] 17b-295, as
amended by this act, 17b-297a, 17b-297b and 17b-300:
(1) "Applicant" means an individual over the age of eighteen years
who is a natural or adoptive parent, a legal guardian, a caretaker
relative, foster parent or stepparent with whom the child resides and
shall include a child who is eighteen years of age or emancipated in
accordance with the provisions of sections 46b-150 to 46b-150e,
inclusive, and who is applying on his own behalf or on behalf of a minor
dependent for coverage under such plan;
(2) "Child" means an individual under nineteen years of age;
(3) "Coinsurance" means the sharing of health care expenses by the
insured and an insurer in a specified ratio;
(4) "Commissioner" means the Commissioner of Social Services;
(5) "Copayment" means a payment made on behalf of a member for a
specified service under HUSKY B;
(6) "Cost sharing" means arrangements made on behalf of a member
whereby an applicant pays a portion of the cost of health services,
sharing costs with the state and includes copayments, premiums,
deductibles and coinsurance;
(7) "Deductible" means the amount of out-of-pocket expenses that
would be paid for health services on behalf of a member before
becoming payable by the insurer;
(8) "Department" means the Department of Social Services;
(9) "Durable medical equipment" means equipment that meets all of Senate Bill No. 909
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the following requirements:
(A) Can withstand repeated use;
(B) Is primarily and customarily used to serve a medical purpose;
(C) Generally is not useful to a person in the absence of an illness or
injury; and
(D) Is nondisposable;
(10) "Eligible beneficiary" means a child who meets the requirements
in section 17b-292, and the requirements specified in Section
2110(b)(2)(B) of the Social Security Act as amended by Section
10203(b)(2)(D) of the Affordable Care Act;
(11) "Household" has the same meaning as provided in 42 CFR
435.603;
(12) "Household income" has the same meaning as provided in 42
CFR 435.603;
(13) "HUSKY A" means Medicaid provided to children, caretaker
relatives and pregnant and postpartum women pursuant to section 17b-
261 or 17b-277;
(14) "HUSKY B" means the health coverage for children established
pursuant to the provisions of sections 17b-290, as amended by this act,
17b-292, [17b-294a,] 17b-295, 17b-297a, 17b-297b and 17b-300;
(15) "HUSKY C" means Medicaid provided to individuals who are
sixty-five years of age or older or who are blind or have a disability;
(16) "HUSKY D" or "Medicaid Coverage for the Lowest Income
Populations program" means Medicaid provided to nonpregnant low-
income adults who are age eighteen to sixty-four, as authorized Senate Bill No. 909
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pursuant to section 17b-8a;
(17) "HUSKY Health" means the combined HUSKY A , HUSKY B,
HUSKY C and HUSKY D programs, that provide medical coverage to
eligible children, parents, relative caregivers, persons age sixty-five or
older, individuals with disabilities, low-income adults, and pregnant
women;
[(18) "HUSKY Plus" means the supplemental health program
established pursuant to section 17b-294a for medically eligible members
of HUSKY B whose medical needs cannot be accommodated within the
basic benefit package offered to members. HUSKY Plus shall
supplement coverage for those medically eligible members with
intensive physical health needs;]
[(19)] (18) "Member" means an eligible beneficiary who receives
services under HUSKY A, B, C or D;
[(20)] (19) "Parent" means a natural parent, stepparent, adoptive
parent, guardian or custodian of a child;
[(21)] (20) "Premium" means any required payment made by an
individual to offset the cost under HUSKY B;
[(22)] (21) "Qualified entity" means any entity: (A) Eligible for
payments under a state plan approved under Medicaid and which
provides medical services under HUSKY A, or (B) that is a qualified
entity, as defined in 42 USC 1396r-1a, as amended by Section 708 of
Public Law 106-554, and that is determined by the commissioner to be
capable of making the determination of eligibility. The commissioner
shall provide qualified entities with such forms or information on filing
an application electronically as is necessary for an application to be
made on behalf of a child under HUSKY A and information on how to
assist parents, guardians and other persons in completing and filing
such forms or electronic application; Senate Bill No. 909
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[(23)] (22) "WIC" means the federal Special Supplemental Food
Program for Women, Infants and Children administered by the
Department of Public Health pursuant to section 19a-59c.
Sec. 4. Section 17b-304 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
The Commissioner of Social Services shall implement the policies and
procedures necessary to carry out the provisions of sections 17b-292,
[17b-294a,] 17b-295, as amended by this act, 17b-297a, 17b-297b and 17b-
300 while in the process of adopting such policies and procedures in
regulation form, provided notice of intent to adopt the regulations is
published on the Department of Social Services' Internet web site and
the eRegulations System not later than twenty days after
implementation. Such policies and procedures shall be valid until the
time final regulations are effective.
Sec. 5. Subdivision (4) of subsection (b) of section 12-202a of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective from passage):
(4) Any new or renewal contract or policy entered into with the state
on or after April 1, 1998, to provide health care coverage to eligible
beneficiaries under the HUSKY Health program, [or HUSKY Plus
program, each] as defined in section 17b-290;
Sec. 6. Subsection (b) of section 12-202b of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) The amount of credit allowed shall be equal to fifty-five dollars
multiplied by the sum of the number of persons provided health care
coverage by the taxpayer under the HUSKY Health program, [or the
HUSKY Plus program, each] as defined in section 17b-290, as amended
by this act, on the first day of each month of the income year for which Senate Bill No. 909
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the credit is taken, divided by twelve.
Sec. 7. Subsection (b) of section 12-202c of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) For the fiscal year ending June 30, 2003, any company that
received a payment under subsection (a) of this section shall be entitled
to an additional supplemental payment equal to thirty-six dollars and
seventy-five cents multiplied by the sum of the number of persons
provided health care coverage by the taxpayer under the HUSKY Health
program, [or the HUSKY Plus program, each] as defined in section 17b-
290, as amended by this act, on the first day of each month, January to
June, inclusive, of 2002, divided by six.
Sec. 8. Section 17b-294a of the general statutes is repealed. (Effective
from passage)