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General Assembly Committee Bill No. 985
January Session, 2025
LCO No. 4940
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING LEGISLATIVE APPROVAL FOR CHANGES TO
THE HUSKY HEALTH PROGRAM REIMBURSEMENT AND CARE
DELIVERY MODEL.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2025) (a) The Commissioner of 1
Social Services shall submit any proposal to change the fee-for-service 2
Medicaid payment model to a managed care payment model to the joint 3
standing committees of the General Assembly having cognizance of 4
matters relating to human services and appropriations and the budgets 5
of state agencies for approval, denial or modification before 6
implementing such change or seeking any necessary federal approval to 7
implement such change. Not later than sixty days after the date of their 8
receipt of such proposal, said joint standing committees shall hold a 9
public hearing on the proposal. Not later than thirty days before such 10
hearing, said joint standing committees shall inform the commissioner, 11
in writing, of the date and time of such hearing and invite the 12
commissioner to testify on the reasons for such proposal, including, but 13
not limited to, (1) any costs or benefits to the state, (2) the expected 14
impact on care provided to Medicaid recipients, and (3) the expected 15
impact on Medicaid reimbursements to providers of such care. At the 16
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conclusion of such hearing, said joint standing committees shall advise 17
the commissioner of their approval, denial or modifications, if any, of 18
the commissioner's proposal. If said joint standing committees advise 19
the commissioner of their denial, the commissioner shall not implement 20
the proposal or seek any necessary federal approval to implement the 21
proposal. 22
(b) If said joint standing committees do not concur, the committee 23
chairpersons shall appoint a committee of conference, which shall be 24
composed of three members from each joint standing committee. At 25
least one member appointed from each joint standing committee shall 26
be a member of the minority party. The report of the committee of 27
conference shall be made to each joint standing committee, which shall 28
vote to accept or reject the report. The report of the committee of 29
conference may not be amended. If one joint standing committee rejects 30
the report of the committee of conference, the proposal shall be deemed 31
denied. If said joint standing committees accept the report, the 32
committee having cognizance of matters relating to appropriations and 33
the budgets of state agencies shall advise the commissioner of their 34
approval, denial or modifications, if any, of the commissioner's 35
proposal. If said joint standing committees do not so advise the 36
commissioner during the thirty-day period, the proposal shall be 37
deemed denied. 38
(c) Any application for a federal waiver, waiver renewal or proposed 39
Medicaid state plan amendment submitted to the federal government 40
by the commissioner to implement a proposal under subsection (a) of 41
this section shall be in accordance with the approval or modifications, if 42
any, of the joint standing committees of the General Assembly having 43
cognizance of matters relating to human services and appropriations 44
and the budgets of state agencies. 45
(d) Thirty days prior to submission of such proposal to said joint 46
standing committees pursuant to subsection (a) of this section, the 47
Commissioner of Social Services shall post a notice that the 48
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commissioner intends to seek approval for such proposal on the 49
Department of Social Services' Internet web site, along with a summary 50
of the provisions of such proposal and the manner in which individuals 51
may submit comments. The commissioner shall allow thirty days for 52
written comments on such proposal and shall include all written 53
comments with the submission of such proposal to said joint standing 54
committees. 55
(e) The commissioner shall include with any application for federal 56
approval of such proposal: (1) Any written comments received pursuant 57
to subsection (d) of this section; and (2) any additional written 58
comments submitted to said joint standing committees at such 59
proceedings. Said joint standing committees shall transmit any such 60
materials to the commissioner for inclusion with any such application 61
for federal approval. 62
Sec. 2. Subsection (a) of section 17a-460c of the general statutes is 63
repealed and the following is substituted in lieu thereof (Effective July 1, 64
2025): 65
(a) The center, when authorized by the commissioner, may enter into 66
provider agreements and other contractual arrangements with the 67
Medicaid fee-for-service program and Medicare managed care plans, 68
governmental health plans, health maintenance organizations, health 69
insurance plans, employer and union health plans, preferred provider 70
organizations, physician-hospital organizations, managed care plans, 71
networks and other similar arrangements or plans offered by insurers, 72
third-party payers or other entities offering health care plans to their 73
members or employees and their dependents. 74
Sec. 3. Section 17b-28 of the general statutes is repealed and the 75
following is substituted in lieu thereof (Effective July 1, 2025): 76
(a) There is established a Council on Medical Assistance Program 77
Oversight which shall advise the Commissioner of Social Services on the 78
planning and implementation of the health care delivery system for the 79
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HUSKY Health program. The council shall monitor planning and 80
implementation of matters related to Medicaid care management 81
initiatives including, but not limited to, (1) eligibility standards, (2) 82
benefits, (3) access, (4) quality assurance, (5) outcome measures, and (6) 83
the issuance of any request for proposal by the Department of Social 84
Services for utilization of an administrative services organization in 85
connection with such initiatives. 86
[(b) On or before June 30, 2011, the council shall be composed of the 87
chairpersons and ranking members of the joint standing committees of 88
the General Assembly having cognizance of matters relating to human 89
services, public health and appropriations and the budgets of state 90
agencies, or their designees; two members of the General Assembly, one 91
to be appointed by the president pro tempore of the Senate and one to 92
be appointed by the speaker of the House of Representatives; the 93
director of the Commission on Aging, or a designee; the director of the 94
Commission on Children, or a designee; a representative of each 95
organization that has been selected by the state to provide managed care 96
and a representative of a primary care case management provider, to be 97
appointed by the president pro tempore of the Senate; two 98
representatives of the insurance industry, to be appointed by the 99
speaker of the House of Representatives; two advocates for persons 100
receiving Medicaid, one to be appointed by the majority leader of the 101
Senate and one to be appointed by the minority leader of the Senate; one 102
advocate for persons with substance use disorders, to be appointed by 103
the majority leader of the House of Representatives; one advocate for 104
persons with psychiatric disabilities, to be appointed by the minority 105
leader of the House of Representatives; two advocates for the 106
Department of Children and Families foster families, one to be 107
appointed by the president pro tempore of the Senate and one to be 108
appointed by the speaker of the House of Representatives; two members 109
of the public who are currently recipients of Medicaid, one to be 110
appointed by the majority leader of the House of Representatives and 111
one to be appointed by the minority leader of the House of 112
Representatives; two representatives of the Department of Social 113
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Services, to be appointed by the Commissioner of Social Services; two 114
representatives of the Department of Public Health, to be appointed by 115
the Commissioner of Public Health; two representatives of the 116
Department of Mental Health and Addiction Services, to be appointed 117
by the Commissioner of Mental Health and Addiction Services; two 118
representatives of the Department of Children and Families, to be 119
appointed by the Commissioner of Children and Families; two 120
representatives of the Office of Policy and Management, to be appointed 121
by the Secretary of the Office of Policy and Management; and one 122
representative of the office of the State Comptroller, to be appointed by 123
the State Comptroller. 124
(c) On and after October 31, 2017, the] 125
(b) The council shall be composed of the following members: 126
(1) The chairpersons and ranking members of the joint standing 127
committees of the General Assembly having cognizance of matters 128
relating to aging, human services, public health and appropriations and 129
the budgets of state agencies, or their designees; 130
(2) Five appointed by the speaker of the House of Representatives, 131
one of whom shall be a member of the General Assembly, one of whom 132
shall be a community provider of adult Medicaid health services, one of 133
whom shall be a recipient of Medicaid benefits for the aged, blind and 134
disabled or an advocate for such a recipient, one of whom shall be a 135
representative of the state's federally qualified health clinics and one of 136
whom shall be a member of the Connecticut Hospital Association; 137
(3) Five appointed by the president pro tempore of the Senate, one of 138
whom shall be a member of the General Assembly, one of whom shall 139
be a representative of the home health care industry, one of whom shall 140
be a primary care medical home provider, one of whom shall be an 141
advocate for Department of Children and Families foster families and 142
one of whom shall be a representative of the business community with 143
experience in cost efficiency management; 144
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(4) Three appointed by the majority leader of the House of 145
Representatives, one of whom shall be an advocate for persons with 146
substance abuse disabilities, one of whom shall be a Medicaid dental 147
provider and one of whom shall be a representative of the for-profit 148
nursing home industry; 149
(5) Three appointed by the majority leader of the Senate, one of whom 150
shall be a representative of school-based health centers, one of whom 151
shall be a recipient of benefits under the HUSKY Health program and 152
one of whom shall be a physician who serves Medicaid clients; 153
(6) Three appointed by the minority leader of the House of 154
Representatives, one of whom shall be an advocate for persons with 155
disabilities, one of whom shall be a dually eligible Medicaid-Medicare 156
beneficiary or an advocate for such a beneficiary and one of whom shall 157
be a representative of the not-for-profit nursing home industry; 158
(7) Three appointed by the minority leader of the Senate, one of 159
whom shall be a low-income adult recipient of Medicaid benefits or an 160
advocate for such a recipient, one of whom shall be a representative of 161
hospitals and one of whom shall be a representative of the business 162
community with experience in cost efficiency management; 163
(8) The executive director of the Commission on Women, Children, 164
Seniors, Equity and Opportunity, or the executive director's designee; 165
(9) A member of the Commission on Women, Children, Seniors, 166
Equity and Opportunity, designated by the executive director of said 167
commission; 168
(10) A representative of the Long-Term Care Advisory Council; 169
(11) The Commissioners of Social Services, Children and Families, 170
Public Health, Developmental Services, Aging and Disability Services 171
and Mental Health and Addiction Services, or their designees, who shall 172
be ex-officio nonvoting members; 173
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(12) The Comptroller, or the Comptroller's designee, who shall be an 174
ex-officio nonvoting member; 175
(13) The Secretary of the Office of Policy and Management, or the 176
secretary's designee, who shall be an ex-officio nonvoting member; and 177
(14) One representative of an administrative services organization 178
which contracts with the Department of Social Services in the 179
administration of the Medicaid program, who shall be a nonvoting 180
member. 181
[(d)] (c) The council shall choose a chairperson from among its 182
members. The Joint Committee on Legislative Management shall 183
provide administrative support to such chairperson. 184
[(e)] (d) The council shall monitor and make recommendations 185
concerning: (1) An enrollment process that ensures access for the 186
HUSKY Health program and effective outreach and client education for 187
said program; (2) available services comparable to those already in the 188
Medicaid state plan, including those guaranteed under the federal Early 189
and Periodic Screening, Diagnostic and Treatment Services Program 190
under 42 USC 1396d; (3) the sufficiency of accessible adult and child 191
primary care providers, specialty providers and hospitals in Medicaid 192
provider networks; (4) the sufficiency of provider rates to maintain the 193
Medicaid network of providers and service access; (5) funding and 194
agency personnel resources to guarantee timely access to services and 195
effective management of the Medicaid program; (6) participation in care 196
management programs including, but not limited to, medical home and 197
health home models by existing community Medicaid providers; (7) the 198
linguistic and cultural competency of providers and other program 199
facilitators and data on the provision of Medicaid linguistic translation 200
services; (8) program quality, including outcome measures and 201
continuous quality improvement initiatives that may include provider 202
quality performance incentives and performance targets for 203
administrative services organizations; (9) timely, accessible and 204
effective client grievance procedures; (10) coordination of the Medicaid 205
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care management programs with state and federal health care reforms; 206
(11) eligibility levels for inclusion in the programs; (12) enrollee cost-207
sharing provisions; (13) a benefit package for the HUSKY Health 208
program; (14) coordination of coverage continuity among Medicaid 209
programs and integration of care, including, but not limited to, 210
behavioral health, dental and pharmacy care provided through 211
programs administered by the Department of Social Services; and (15) 212
the need for program quality studies within the areas identified in this 213
section and the department's application for available grant funds for 214
such studies. The chairperson of the council shall ensure that sufficient 215
members of the council participate in the review of any contract entered 216
into by the Department of Social Services and an administrative services 217
organization. 218
[(f)] (e) The Commissioner of Social Services may, in consultation 219
with an educational institution, apply for any available funding, 220
including federal funding, to support Medicaid care management 221
programs. 222
[(g)] (f) The Commissioner of Social Services shall provide monthly 223
reports to the council on the matters described in subsection [(e)] (d) of 224
this section, including, but not limited to, policy changes and proposed 225
regulations that affect Medicaid health services. The commissioner shall 226
also provide the council with quarterly financial reports for each 227
covered Medicaid population which reports shall include a breakdown 228
of sums expended for each covered population. 229
[(h)] (g) The council shall biannually report on its activities and 230
progress to the General Assembly. 231
[(i)] (h) There is established, within the Council on Medical 232
Assistance Program Oversight, a standing subcommittee to study and 233
make recommendations to the council on children and adults who have 234
complex health care needs. The subcommittee shall consist of council 235
members appointed by the chairpersons of the council and other 236
individuals who shall serve for terms prescribed by the cochairpersons 237
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to advise the council on specific needs of children and adults with 238
complex health care needs. For the purposes of completing the reports 239
required pursuant to subparagraphs (A) and (B) of this subsection, such 240
individuals shall include, but need not be limited to: (1) The Child 241
Advocate, or the Child Advocate's designee; (2) a family or child 242
advocate; (3) the executive director of the Council on Developmental 243
Disabilities, or the executive director's designee; (4) the executive 244
director of the Connecticut Association of Public School 245
Superintendents, or the executive director's designee; (5) an expert in 246
the diagnosis, evaluation, education and treatment of children and 247
young adults with developmental disabilities; and (6) the Healthcare 248
Advocate, or the Healthcare Advocate's designee. The subcommittee 249
shall submit the following reports, in accordance with section 11-4a to 250
the council, the Governor and the joint standing committees of the 251
General Assembly having cognizance of matters relating to children, 252
human services and public health regarding the efficacy of support 253
systems for children and young adults, not older than twenty-one years 254
of age, with developmental disabilities and with or without co-255
occurring mental health conditions: 256
(A) Not later than July 1, 2017, recommendations including, but not 257
limited to: (i) Metrics for evaluating the quality of state-funded services 258
to such children and young adults that can be utilized by state agencies 259
that fund such services; (ii) statutory changes needed to promote 260
effective service delivery for such children and young adults and their 261
families; and (iii) any other changes needed to address gaps in services 262
identified by the subcommittee or council with respect to such children, 263
young adults and their families; and 264
(B) Not later than January 1, 2018, an assessment of: (i) Early 265
intervention services available to such children and young adults in this 266
state; (ii) the system of community-based services for such children and 267
young adults; (iii) the treatment provided by congregate care settings 268
that are operated privately or by the state and provide residential 269
supports and services to such children and young adults and how the 270
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quality of care is measured; and (iv) how the state Department of 271
Education, local boards of education, the Department of Children and 272
Families, the Department of Developmental Services and other 273
appropriate agencies can work collaboratively to improve educational, 274
developmental, medical and behavioral health outcomes for such 275
children and young adults and reduce the number at risk of entering 276
institutional care. As used in this subsection, "developmental disability" 277
means a severe, chronic disability of an individual, as defined in 42 USC 278
15002, as amended from time to time. 279
Sec. 4. Section 17b-28h of the general statutes is repealed and the 280
following is substituted in lieu thereof (Effective July 1, 2025): 281
The Commissioner of Social Services may, to the extent permitted by 282
federal law, amend the Medicaid state plan to establish a pilot program 283
that serves not more than five hundred persons served by Oak Hill - The 284
Connecticut Institute for the Blind, Inc. who are eligible for Medicare 285
and who voluntarily agree to participate in the program. Such program 286
shall be designed to demonstrate the feasibility and cost effectiveness of 287
delivering comprehensive health insurance coverage [in a managed care 288
setting] to such persons. The commissioner may include medical 289
assistance services in the program not covered on October 5, 2009, in the 290
state medical assistance program or other modifications to the state 291
medical assistance program to encourage voluntary participation in the 292
pilot program. 293
Sec. 5. Subsection (b) of section 17b-90 of the general statutes is 294
repealed and the following is substituted in lieu thereof (Effective July 1, 295
2025): 296
(b) No person shall, except for purposes directly connected with the 297
administration of programs of the Department of Social Services and in 298
accordance with the regulations of the commissioner, solicit, disclose, 299
receive or make use of, or authorize, knowingly permit, participate in or 300
acquiesce in the use of, any list of the names of, or any information 301
concerning, persons applying for or receiving assistance from the 302
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Department of Social Services or persons participating in a program 303
administered by said department, directly or indirectly derived from 304
the records, papers, files or communications of the state or its 305
subdivisions or agencies, or acquired in the course of the performance 306
of official duties. The Commissioner of Social Services shall disclose (1) 307
to any authorized representative of the Labor Commissioner such 308
information directly related to unemployment compensation, 309
administered pursuant to chapter 567 or information necessary for 310
implementation of sections 17b-112l, 17b-688b, 17b-688c and 17b-688h 311
and section 122 of public act 97-2 of the June 18 special session, (2) to 312
any authorized representative of the Commissioner of Mental Health 313
and Addiction Services any information necessary for the 314
implementation and operation of the basic needs supplement program, 315
(3) to any authorized representative of the Commissioner of 316
Administrative Services or the Commissioner of Emergency Services 317
and Public Protection such information as the Commissioner of Social 318
Services determines is directly related to and necessary for the 319
Department of Administrative Services or the Department of 320
Emergency Services and Public Protection for purposes of performing 321
their functions of collecting social services recoveries and overpayments 322
or amounts due as support in social services cases, investigating social 323
services fraud or locating absent parents of public assistance recipients, 324
(4) to any authorized representative of the Commissioner of Children 325
and Families necessary information concerning a child or the immediate 326
family of a child receiving services from the Department of Social 327
Services, including safety net services, if (A) the Commissioner of 328
Children and Families or the Commissioner of Social Services has 329
determined that imminent danger to such child's health, safety or 330
welfare exists to target the services of the family services programs 331
administered by the Department of Children and Families, or (B) the 332
Commissioner of Children and Families requires access to the federal 333
Parent Locator Service established pursuant to 42 USC 653 in order to 334
identify a parent or putative parent of a child, (5) to a town official or 335
other contractor or authorized representative of the Labor 336
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Commissioner such information concerning an applicant for or a 337
recipient of assistance under state-administered general assistance 338
deemed necessary by the Commissioner of Social Services and the Labor 339
Commissioner to carry out their respective responsibilities to serve such 340
persons under the programs administered by the Labor Department 341
that are designed to serve applicants for or recipients of state-342
administered general assistance, (6) to any authorized representative of 343
the Commissioner of Mental Health and Addiction Services for the 344
purposes of the behavioral health [managed care] program established 345
by section 17a-453, (7) to any authorized representative of the 346
Commissioner of Early Childhood to carry out his or her respective 347
responsibilities under the two-generational academic achievement and 348
workforce readiness initiative established pursuant to section 17b-112l 349
and programs that regulate child care services or youth camps, (8) to a 350
health insurance provider, in IV-D support cases, as defined in 351
subdivision (13) of subsection (b) of section 46b-231, information 352
concerning a child and the custodial parent of such child that is 353
necessary to enroll such child in a health insurance plan available 354
through such provider when the noncustodial parent of such child is 355
under court order to provide health insurance coverage but is unable to 356
provide such information, provided the Commissioner of Social 357
Services determines, after providing prior notice of the disclosure to 358
such custodial parent and an opportunity for such parent to object, that 359
such disclosure is in the best interests of the child, (9) to any authorized 360
representative of the Department of Correction, in IV-D support cases, 361
as defined in subdivision (13) of subsection (b) of section 46b-231, 362
information concerning noncustodial parents that is necessary to 363
identify inmates or parolees with IV-D support cases who may benefit 364
from Department of Correction educational, training, skill building, 365
work or rehabilitation programming that will significantly increase an 366
inmate's or parolee's ability to fulfill such inmate's support obligation, 367
(10) to any authorized representative of the Judicial Branch, in IV-D 368
support cases, as defined in subdivision (13) of subsection (b) of section 369
46b-231, information concerning noncustodial parents that is necessary 370
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to: (A) Identify noncustodial parents with IV-D support cases who may 371
benefit from educational, training, skill building, work or rehabilitation 372
programming that will significantly increase such parent's ability to 373
fulfill such parent's support obligation, (B) assist in the administration 374
of the Title IV-D child support program, or (C) assist in the identification 375
of cases involving family violence, (11) to any authorized representative 376
of the State Treasurer, in IV-D support cases, as defined in subdivision 377
(13) of subsection (b) of section 46b-231, information that is necessary to 378
identify child support obligors who owe overdue child support prior to 379
the Treasurer's payment of such obligors' claim for any property 380
unclaimed or presumed abandoned under part III of chapter 32, (12) to 381
any authorized representative of the Secretary of the Office of Policy and 382
Management any information necessary for the implementation and 383
operation of the renters rebate program established by section 12-170d, 384
or (13) to any authorized representative of the Department of Aging and 385
Disability Services, or to an area agency on aging contracting with said 386
department to provide services under the elderly nutrition program, 387
information on persons enrolled in the supplemental nutrition 388
assistance program who have requested or been recommended to 389
receive elderly nutrition program services. No such representative shall 390
disclose any information obtained pursuant to this section, except as 391
specified in this section. Any applicant for assistance provided through 392
the Department of Social Services shall be notified that, if and when such 393
applicant receives benefits, the department will be providing law 394
enforcement officials with the address of such applicant upon the 395
request of any such official pursuant to section 17b-16a. 396
Sec. 6. Section 17b-265c of the general statutes is repealed and the 397
following is substituted in lieu thereof (Effective July 1, 2025): 398
The Commissioner of Social Services, to the extent permitted by 399
federal law, shall amend the Medicaid state plan to establish a pilot 400
program serving not more than five hundred elderly or disabled state 401
medical assistance recipients who are also eligible for Medicare and who 402
voluntarily opt to participate in the program. Such program shall 403
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demonstrate the feasibility and cost effectiveness of delivering 404
comprehensive health insurance coverage [in a managed care setting] to 405
such recipients. The commissioner may include medical assistance 406
services in the pilot program not presently covered in the state medical 407
assistance program or other modifications to the state medical assistance 408
program to encourage voluntary participation in the pilot program. 409
Sec. 7. Section 17b-10a of the general statutes is repealed and the 410
following is substituted in lieu thereof (Effective July 1, 2025): 411
The Commissioner of Social Services, pursuant to section 17b-10, may 412
implement policies and procedures necessary to administer [section 413
17b-197, subsection (d) of section 17b-266, section] sections 17b-197, 17b-414
280a and subsection (a) of section 17b-295, while in the process of 415
adopting such policies and procedures as regulation, provided the 416
commissioner prints notice of intent to adopt regulations on the 417
department's Internet web site and the eRegulations System not later 418
than twenty days after the date of implementation. Policies and 419
procedures implemented pursuant to this section shall be valid until the 420
time final regulations are adopted. 421
Sec. 8. Sections 17b-28b and 17b-266 of the general statutes are 422
repealed. (Effective July 1, 2025) 423
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2025 New section
Sec. 2 July 1, 2025 17a-460c(a)
Sec. 3 July 1, 2025 17b-28
Sec. 4 July 1, 2025 17b-28h
Sec. 5 July 1, 2025 17b-90(b)
Sec. 6 July 1, 2025 17b-265c
Sec. 7 July 1, 2025 17b-10a
Sec. 8 July 1, 2025 Repealer section
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Statement of Purpose:
To require legislative approval for changes to the HUSKY Health
program reimbursement and care delivery model.
[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.]
Co-Sponsors: SEN. LOONEY, 11th Dist.
S.B. 985