Sec. 17b-256f. Eligibility for Medicare savings programs. Regulations.
Sec. 17b-261f. Mobile field hospital account.
Sec. 17b-278o. Medicaid coverage for sickle cell disease gene therapies.
Sec. 17b-288. Organ transplant account. Regulations.
Sec. 17b-238. (Formerly Sec. 17-311). *(See end of section for amended version of subsection (b) and effective date.) State payments to hospitals. (a) The Commissioner of Social Services shall establish annually the cost of services for which payment is to be made under the provisions of section 17b-239. All hospitals receiving state aid shall submit their cost data under oath on forms approved by the commissioner. The commissioner may adopt, in accordance with the provisions of chapter 54, regulations concerning the submission of data by institutions and agencies to which payments are to be made under sections 17b-239, 17b-243, 17b-244, 17b-340, 17b-341 and section 17b-343, and the defining of policies utilized by the commissioner in establishing rates under said sections, which data and policies are necessary for the efficient administration of said sections. The commissioner shall provide, upon request, a statement of interpretation of the Medicaid cost-related reimbursement system regulations for long-term care facilities reimbursed under section 17b-340 concerning allowable and unallowable costs or expenditures. Such statement of interpretation shall not be construed to constitute a regulation violative of chapter 54. Failure of such statement of interpretation to address a specific unallowable cost or expenditure fact pattern shall in no way prevent the commissioner from enforcing all applicable laws and regulations.
*(b) Any institution or agency to which payments are to be made under sections 17b-239 to 17b-246, inclusive, and sections 17b-340 and 17b-343 which is aggrieved by any decision of said commissioner may, within ten days after written notice thereof from the commissioner, obtain, by written request to the commissioner, a rehearing on all items of aggrievement. On and after July 1, 1996, a rehearing shall be held by the commissioner or his designee, provided a detailed written description of all such items is filed within ninety days of written notice of the commissioner's decision. The rehearing shall be held within thirty days of the filing of the detailed written description of each specific item of aggrievement. The commissioner shall issue a final decision within sixty days of the close of evidence or the date on which final briefs are filed, whichever occurs later. Any designee of the commissioner who presides over such rehearing shall be impartial and shall not be employed within the Department of Social Services office of certificate of need and rate setting. Any such items not resolved at such rehearing to the satisfaction of either such institution or agency or said commissioner shall be submitted to binding arbitration to an arbitration board consisting of one member appointed by the institution or agency, one member appointed by the commissioner and one member appointed by the Chief Court Administrator from among the retired judges of the Superior Court, which retired judge shall be compensated for his services on such board in the same manner as a state referee is compensated for his services under section 52-434. The proceedings of the arbitration board and any decisions rendered by such board shall be conducted in accordance with the provisions of the Social Security Act, 49 Stat. 620 (1935), 42 USC 1396, as amended from time to time, and chapter 54.
(c) The submission of any false or misleading fiscal information or data to said commissioner shall be grounds for suspension of payments by the state under sections 17b-239 to 17b-246, inclusive, and sections 17b-340 and 17b-343 in accordance with regulations adopted by said commissioner. In addition, any person, including any corporation, who knowingly makes or causes to be made any false or misleading statement or who knowingly submits false or misleading fiscal information or data on the forms approved by the commissioner shall be guilty of a class D felony.
(d) Said commissioner, or any agent authorized by the commissioner to conduct any inquiry, investigation or hearing under the provisions of this section, shall have power to administer oaths and take testimony under oath relative to the matter of inquiry or investigation. At any hearing ordered by the commissioner, the commissioner or such agent having authority by law to issue such process may subpoena witnesses and require the production of records, papers and documents pertinent to such inquiry. If any person disobeys such process or, having appeared in obedience thereto, refuses to answer any pertinent question put to him by the commissioner or his authorized agent or to produce any records and papers pursuant thereto, the commissioner or his agent may apply to the superior court for the judicial district of Hartford or for the judicial district wherein the person resides or wherein the business has been conducted, or to any judge of said court if the same is not in session, setting forth such disobedience to process or refusal to answer, and said court or such judge shall cite such person to appear before said court or such judge to answer such question or to produce such records and papers.
(1949, 1953, S. 1585d; 1961, P.A. 474, S. 1; February, 1965, P.A. 146; 1969, P.A. 506; 642, S. 1; 1971, P.A. 300; P.A. 73-117, S. 22, 31; P.A. 75-420, S. 4, 6; 75-562, S. 5, 8; P.A. 76-244; 76-436, S. 10a, 592, 681; P.A. 77-574, S. 3, 6; 77-593, S. 3, 4; 77-614, S. 19, 344, 587, 610; P.A. 78-264, S. 1, 4; 78-280, S. 1, 5, 127; 78-303, S. 85, 136; P.A. 79-182, S. 2, 4; P.A. 80-196, S. 1, 2; P.A. 81-249; P.A. 83-73; P.A. 86-319, S. 2; P.A. 88-156, S. 18; 88-230, S. 1, 12; 88-317, S. 74, 107; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; 93-262, S. 1, 87; P.A. 95-220, S. 4-6; 95-351, S. 24, 30.)
*Note: On and after January 1, 2027, subsection (b) of this section, as amended by section 348 of public act 25-168, is to read as follows:
“Sec. 17b-238. (Formerly Sec. 17-311). State payments to hospitals, other institutions and agencies. Appeal process.
(b) Any institution or agency to which payments are to be made under sections 17b-239 to 17b-246, inclusive, and sections 17b-340 and 17b-343 which is aggrieved by any decision of said commissioner may, within ten days after written notice thereof from the commissioner, obtain, by written request to the commissioner, a rehearing on all items of aggrievement. On and after July 1, 1996, a rehearing shall be held by the commissioner or his designee, provided a detailed written description of all such items is filed within ninety days of written notice of the commissioner's decision. The rehearing shall be held within thirty days of the filing of the detailed written description of each specific item of aggrievement. The commissioner shall issue a final decision within sixty days of the close of evidence or the date on which final briefs are filed, whichever occurs later. Any designee of the commissioner who presides over such rehearing shall be impartial and shall not be employed within the Department of Social Services office of certificate of need and rate setting. Any such items not resolved at such rehearing to the satisfaction of either such institution or agency or said commissioner may be appealed in accordance with section 4-183. Such appeals shall be privileged cases to be heard by the court as soon after the return date as shall be practicable.”
(1949, 1953, S. 1585d; 1961, P.A. 474, S. 1; February, 1965, P.A. 146; 1969, P.A. 506; 642, S. 1; 1971, P.A. 300; P.A. 73-117, S. 22, 31; P.A. 75-420, S. 4, 6; 75-562, S. 5, 8; P.A. 76-244; 76-436, S. 10a, 592, 681; P.A. 77-574, S. 3, 6; 77-593, S. 3, 4; 77-614, S. 19, 344, 587, 610; P.A. 78-264, S. 1, 4; 78-280, S. 1, 5, 127; 78-303, S. 85, 136; P.A. 79-182, S. 2, 4; P.A. 80-196, S. 1, 2; P.A. 81-249; P.A. 83-73; P.A. 86-319, S. 2; P.A. 88-156, S. 18; 88-230, S. 1, 12; 88-317, S. 74, 107; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; 93-262, S. 1, 87; P.A. 95-220, S. 4-6; 95-351, S. 24, 30; P.A. 25-168, S. 348.)
History: 1961 act added commissioners of finance and control and mental health, deleted requirement that commission prescribe and provide uniform forms and provided that commission approve cost data forms; 1965 act added Subsec. (b); 1969 acts replaced hospital cost analyst with executive director of commission in Subsec. (a) and replaced appeal provisions in Subsec. (b) with provisions for rehearing and required aggrieved hospital to file within 10 days after receiving notice rather than within 30 days; 1971 act replaced state budget director with commissioner of finance and control in Subsec. (a) and added commission's power to make regulations and define policies used in establishing rates; P.A. 73-117 replaced commission with committee, removed commissioner of health as member and added chairman and vice chairman of commission on hospitals and health care and replaced provision concerning executive director with statement that necessary staff will be made available by commission on hospitals and health care; P.A. 75-420 replaced welfare commissioner with commissioner of social services; P.A. 75-562 made department of health responsible for supplying necessary staff; P.A. 76-244 added Subsec. (c) re power to administer oaths, take testimony, issue subpoenas, etc.; P.A. 76-436 replaced chief judge with chief court administrator in Subsec. (b), effective July 1, 1978; P.A. 77-574 replaced “hospital” with “institution or agency …” in Subsec. (b); P.A. 77-593 inserted new Subsec. (c) re submission of false or misleading fiscal information and relettered former Subsec. (c) as Subsec. (d); P.A. 77-614 and P.A. 78-303 replaced commissioner of finance and control with secretary of the office of policy and management as committee member but later provision replaced committee with commissioner of income maintenance and removed reference to staff supplied by health department, effective January 1, 1979; P.A. 78-264 repealed amendments to Subsec. (a) made by P.A. 77-614; P.A. 78-280 replaced “county” with “judicial district” and “Hartford courts”, with “judicial district of Hartford-New Britain”; P.A. 79-182 added reference to Sec. 17-314a in Subsec. (a); P.A. 80-196 required that proceedings of arbitration board be conducted in accordance with Social Security and Uniform Administrative Procedure Act; P.A. 81-249 amended Subsec. (c) to provide that any person, including any corporation, who knowingly makes or causes to be made any false or misleading statement or who knowingly submits false or misleading fiscal information shall be guilty of a class D felony; P.A. 83-73 amended Subsec. (a) to provide for a statement of interpretation of the medicaid cost related reimbursement system regulations; P.A. 86-319 added references to Sec. 17-314c; P.A. 88-156 made a technical correction in Subsec. (b); P.A. 88-230 replaced “judicial district of Hartford-New Britain” with “judicial district of Hartford”, effective September 1, 1991; P.A. 88-317 amended Subsec. (b) by substituting “chapter 54” for “the Uniform Administrative Procedure Act, sections 4-166 to 4-189”, effective July 1, 1989, and applicable to all agency proceedings commencing on or after that date; P.A. 90-98 changed the effective date of P.A. 88-230 from September 1, 1991, to September 1, 1993; P.A. 93-142 changed the effective date of P.A. 88-230 from September 1, 1993, to September 1, 1996, effective June 14, 1993; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-311 transferred to Sec. 17b-238 in 1995; P.A. 95-220 changed the effective date of P.A. 88-230 from September 1, 1996, to September 1, 1998, effective July 1, 1995; P.A. 95-351 amended Subsec. (b) by adding provisions for a rehearing, effective July 1, 1995; P.A. 25-168 amended Subsec. (b) by deleting provisions re binding arbitration and replacing with privileged case appeal process under Sec. 4-183, effective January 1, 2027.
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Sec. 17b-239e. *(See end of section for amended version of subsection (c) and effective date.) Hospital rate plan. Supplemental pools and payments. Quality measures. (a) For the purposes of this section, “settlement agreement” has the same meaning as provided in section 12-263z.
(b) Subject to federal approval, the Department of Social Services shall establish supplemental pools for certain hospitals in accordance with the terms of the settlement agreement, including any court order issued in accordance with the provisions of section 12-263z. Such pools shall include, but not be limited to, as applicable, general, small hospital, mid-sized hospital and large hospital supplemental pools.
*(c) (1) The department shall distribute supplemental payments to applicable hospitals in accordance with the settlement agreement, including any court order issued in accordance with the provisions of section 12-263z. The commissioner shall diligently pursue the federal approvals required for the supplemental pools and payments set forth in this section.
(2) To the extent required by the settlement agreement, including any court order issued in accordance with the provisions of section 12-263z, the Department of Social Services shall pay Medicaid supplemental payments to nongovernmental licensed short-term general hospitals located in the state as follows: (A) For the fiscal years ending June 30, 2020, and June 30, 2021, five hundred forty-eight million three hundred thousand dollars in each such fiscal year; and (B) for the fiscal years ending June 30, 2022, through June 30, 2026, five hundred sixty-eight million three hundred thousand dollars in each such fiscal year. For fiscal years commencing on and after July 1, 2026, the total amount of supplemental payments paid to such hospitals shall continue at the level in effect for the prior fiscal year unless modified through any provision of the general statutes or appropriations act.
(3) From July 1, 2019, through June 30, 2026, the Department of Social Services shall make supplemental payments to the applicable hospitals on or before the last day of the first month of each calendar quarter, except that payments scheduled to be made before December 19, 2019, shall be made not later than thirty days after December 19, 2019.
(4) If a nongovernmental licensed short-term general hospital located in the state merges or consolidates with or is acquired by another hospital, such that the hospital does not continue to maintain a separate short-term general hospital license, the supplemental payments that would have been paid to the hospital that no longer maintains such license shall be paid instead to the surviving hospital, beginning with the first calendar quarter that commences on or after the effective date of the merger, consolidation or acquisition. If a nongovernmental licensed short-term general hospital located in the state dissolves, ceases to operate or otherwise terminates licensed short-term general hospital services, the supplemental payments that would have been paid to such hospital shall not be paid to any other hospital for the remainder of the fiscal year in which such hospital dissolves, ceases operations or otherwise terminates such services. Commencing with the fiscal year after the hospital dissolved, ceased to operate or otherwise terminated such services, the supplemental payments that would have been made to such hospital shall be redistributed to all other nongovernmental licensed short-term general hospitals located in the state in accordance with the distribution methodology set forth in the settlement agreement for each supplemental pool.
(5) Both the state and federal share of supplemental payments set forth in this subsection shall be appropriated to the Department of Social Services. Such supplemental payments shall not be subject to rescissions or holdbacks. Nothing in this section shall affect the authority of the state to recover overpayments and collect unpaid liabilities, as authorized by law.
(d) To the extent required by the settlement agreement, including any court order issued in accordance with the provisions of section 12-263z, the commissioner shall make the supplemental payments set forth in this section effective for the dates of service set forth in this section, including payment adjustments to reconcile, in accordance with this section, supplemental payments made to hospitals for the calendar quarter ending September 30, 2019, as interim payments. Such reconciliation shall ensure that, after accounting for such payment adjustments, the actual supplemental payments made to each hospital shall be the amounts due to each hospital pursuant to the settlement agreement, even if federal approvals are received after each applicable date that supplemental payments are required to be made, provided the supplemental payments remain subject to federal approval. If federal approval of such payments is not obtained, such payments may later be recovered by the commissioner by recoupment against other Medicaid payments due to a hospital or in any manner authorized by law.
(P.A. 11-44, S. 112; 11-61, S. 121; Dec. Sp. Sess. P.A. 12-1, S. 5; P.A. 13-234, S. 77; June Sp. Sess. P.A. 15-5, S. 382; June Sp. Sess. P.A. 17-2, S. 618; June Sp. Sess. P.A. 17-4, S. 11; P.A. 18-81, S. 55; P.A. 19-117, S. 307; Dec. Sp. Sess. P.A. 19-1, S. 6.)
*Note: On and after July 1, 2026, subsection (c) of this section, as amended by section 362 of public act 25-168, is to read as follows:
“Sec. 17b-239e. Hospital rate plan. Supplemental pools and payments.
(c) (1) From July 1, 2019, through June 30, 2026, the department shall distribute supplemental payments to applicable hospitals in accordance with the settlement agreement, including any court order issued in accordance with the provisions of section 12-263z. The commissioner shall diligently pursue the federal approvals required for the supplemental pools and payments set forth in this section.
(2) To the extent required by the settlement agreement, including any court order issued in accordance with the provisions of section 12-263z, the Department of Social Services shall pay Medicaid supplemental payments to nongovernmental licensed short-term general hospitals located in the state as follows: (A) For the fiscal years ending June 30, 2020, and June 30, 2021, five hundred forty-eight million three hundred thousand dollars in each such fiscal year; and (B) for the fiscal years ending June 30, 2022, through June 30, 2026, five hundred sixty-eight million three hundred thousand dollars in each such fiscal year.
(3) (A) For the fiscal year commencing July 1, 2026, the Department of Social Services shall pay Medicaid supplemental payments to nongovernmental licensed short-term general hospitals located in the state in the amount of seven hundred eight million three hundred thousand dollars. For fiscal years commencing on or after July 1, 2027, the total amount of such supplemental payments paid to such hospitals each fiscal year shall be increased twenty-five million dollars over the total amount of such supplemental payments paid to such hospitals in the immediately preceding fiscal year, provided such supplemental payments shall not be increased for any fiscal year unless the total amount collected for the immediately preceding fiscal year from the tax imposed on inpatient hospital services and outpatient hospital services under section 12-263q, across all hospitals subject to such tax, exceeds such amounts collected for the fiscal year prior to the immediately preceding fiscal year by at least twenty-five million dollars.
(B) The Department of Social Services shall not pay Medicaid supplemental payments in a manner that does not comply with applicable federal requirements and required federal approvals, including, but not limited to, payments that cause total hospital payments in an applicable category to exceed the upper payment limit, as defined in section 17b-239.
(4) From July 1, 2019, through June 30, 2026, the Department of Social Services shall make supplemental payments to the applicable hospitals on or before the last day of the first month of each calendar quarter, except that payments scheduled to be made before December 19, 2019, shall be made not later than thirty days after December 19, 2019.
(5) If a nongovernmental licensed short-term general hospital located in the state merges or consolidates with or is acquired by another hospital, such that the hospital does not continue to maintain a separate short-term general hospital license, the supplemental payments that would have been paid to the hospital that no longer maintains such license shall be paid instead to the surviving hospital, beginning with the first calendar quarter that commences on or after the effective date of the merger, consolidation or acquisition. If a nongovernmental licensed short-term general hospital located in the state dissolves, ceases to operate or otherwise terminates licensed short-term general hospital services, the supplemental payments that would have been paid to such hospital shall not be paid to any other hospital for the remainder of the fiscal year in which such hospital dissolves, ceases operations or otherwise terminates such services. Commencing with the fiscal year after the hospital dissolved, ceased to operate or otherwise terminated such services, the supplemental payments that would have been made to such hospital shall be redistributed to all other nongovernmental licensed short-term general hospitals located in the state in accordance with the distribution methodology set forth in the settlement agreement for each supplemental pool.
(6) Both the state and federal share of supplemental payments set forth in this subsection shall be appropriated to the Department of Social Services. Such supplemental payments shall not be subject to rescissions or holdbacks. Nothing in this section shall affect the authority of the state to recover overpayments and collect unpaid liabilities, as authorized by law.”
(P.A. 11-44, S. 112; 11-61, S. 121; Dec. Sp. Sess. P.A. 12-1, S. 5; P.A. 13-234, S. 77; June Sp. Sess. P.A. 15-5, S. 382; June Sp. Sess. P.A. 17-2, S. 618; June Sp. Sess. P.A. 17-4, S. 11; P.A. 18-81, S. 55; P.A. 19-117, S. 307; Dec. Sp. Sess. P.A. 19-1, S. 6; P.A. 25-168, S. 362.)
History: P.A. 11-44 effective July 1, 2011; P.A. 11-61 amended Subsec. (b) by adding provision excluding utilization as a factor in determining cost neutrality, effective July 1, 2011; Dec. Sp. Sess. P.A. 12-1 amended Subsec. (b) to replace “shall not” with “may” and add “for the fiscal year ending June 30, 2013” re utilization as a factor in determining cost neutrality, effective December 21, 2012; P.A. 13-234 amended Subsec. (b) to add provision re supplemental inpatient pool for low-cost hospitals, and to delete “for the fiscal year ending June 30, 2013.”, effective July 1, 2013; June Sp. Sess. P.A. 15-5 amended Subsec. (b) to replace “shall” with “may” re establishment of supplemental inpatient pool and change “low cost hospitals” to “certain hospitals”, effective July 1, 2015; June Sp. Sess. P.A. 17-2 substantially amended Subsec. (b) including to replace provision re blended inpatient hospital case rate with provisions re establishment of and payments from supplemental pools, effective October 1, 2017; June Sp. Sess. P.A. 17-4 substantially amended Subsec. (b) including adding provisions re establishments of and payments from supplemental pools, effective November 21, 2017; P.A. 18-81 amended Subsec. (b)(2) by adding Subpara. (C) re amount of funds in supplemental pools for the fiscal year ending June 30, 2020, effective July 1, 2018; P.A. 19-117 amended Subsec. (b) by deleting provision re Department of Social Services to publish public notice for Medicaid state plan amendments necessary to establish pools, deleting former Subdiv. (2) re amount of funds in supplemental pools, redesignating existing Subdiv. (3) as new Subdiv. (2) and amending same to delete provision re sending distribution criteria and exception, deleting former Subdiv. (4) re supplemental payments for fiscal years ending June 30, 2018, and June 30, 2019, and adding Subsec. (c) re amounts allocated based on hospital's performance on quality measures, effective July 1, 2019; Dec. Sp. Sess. P.A. 19-1 substantially revised section re establishment of supplemental pools and making of supplemental payments to certain hospitals, effective December 19, 2019; P.A. 25-168 amended Subsec. (c) by adding new Subdiv. (3) re Medicaid supplemental payments for fiscal years commencing on or after July 1, 2026, and making conforming changes in Subdivs. (1) and (2), and redesignating existing Subdivs. (3) to (5) as Subdivs. (4) to (6), effective July 1, 2026.
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Sec. 17b-239f. AHEAD global budget payment methodology for licensed acute care hospitals. Report. Medicaid waiver. (a) The Commissioner of Social Services shall, within available appropriations, develop a methodology and implementation plan for one or more financing structures or alternative payment methodologies for hospital services in the state, including, but not limited to, a global budget payment methodology for licensed acute care hospitals, including, but not limited to, children's hospitals, under the AHEAD federal innovation model administered by the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation. The commissioner shall, not later than January 31, 2026, report, in accordance with the provisions of section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to human services, public health and appropriations and the budgets of state agencies regarding such methodology and implementation plan.
(b) Not earlier than thirty days after submitting such report, the commissioner may apply for a Medicaid research and demonstration waiver under Section 1115 of the Social Security Act to implement a financing structure or alternative payment methodology developed pursuant to the provisions of subsection (a) of this section. If implemented, such financing structure or alternative payment methodology (1) shall apply to each licensed acute care hospital, including, but not limited to, children's hospitals, that voluntarily chooses to participate in such financing structure or alternative payment methodology for all service categories included in such structure or methodology, and (2) may, within available resources dedicated to the implementation of such financing structure or alternative payment methodology, include incentive or other enhanced payments for any such licensed acute care hospital. No state agency shall (A) require any licensed acute care hospital to participate in any financing structure or alternative payment methodology implemented pursuant to the provisions of this section, (B) require any licensed acute care hospital to participate in any such financing structure or alternative payment methodology as a condition of Medicaid reimbursement or approval of a certificate of need application, or (C) impose any penalty or reduction on any licensed acute care hospital as a result of its decision not to participate in any such financing structure or alternative payment methodology.
(P.A. 25-168, S. 47.)
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Sec. 17b-245b. Federally qualified health centers. Reimbursement methodology in the Medicaid program. (a) The Commissioner of Social Services shall, consistent with federal law, reimburse federally qualified health centers on an all-inclusive encounter rate per client encounter based on the prospective payment system required by 42 USC 1396a(bb). Any patient encounter with more than one health professional for the same type of service and multiple interactions with the same health professional that occur on the same day shall constitute a single encounter for purposes of reimbursement, except when the patient, after the first encounter, suffers illness or injury requiring additional diagnosis and treatment. A federally qualified health center shall be reimbursed in accordance with the requirements prescribed in section 17b-262-1002 of the regulations of Connecticut state agencies.
(b) A federally qualified health center may not provide nonemergency periodic dental services on different dates of service for the purpose of billing for separate encounters. Any nonemergency periodic dental service, including, but not limited to, (1) an examination, (2) prophylaxis, and (3) radiographs, including bitewings, complete series and periapical imaging, if warranted, shall be completed in one visit. A second visit to complete any service normally included during the course of a nonemergency periodic dental visit shall not be eligible for reimbursement unless (A) medically necessary, and (B) such medical necessity is clearly documented in the patient's dental record.
(c) Notwithstanding the provisions of subsection (a) of this section, not later than October 1, 2025, the Department of Social Services shall provide an alternative, updated prospective payment methodology for each federally qualified health center that is the same as rates established under the prospective payment system set forth in 42 USC 1396a(bb)(3), as may be amended from time to time, except that the base year for determining the costs of providing such services shall be the average of the reasonable costs incurred in a federally qualified health center's fiscal year ending in 2023, adjusted for any change in scope adjustments approved since the 2023 base year and for inflation as measured by the Medicare Economic Index published by the Centers for Medicare and Medicaid Services, subject to available appropriations and as provided pursuant to this section. Any rebasing established under such alternative, updated prospective payment methodology shall be phased in over the course of three years, commencing during the fiscal year ending June 30, 2026, and concluded during the fiscal year ending June 30, 2028, in accordance with the provisions of section 351 of public act 25-168*. Each federally qualified health center shall be given the option to be reimbursed under the provisions of this subsection or under the prospective payment system pursuant to federal law.
(d) The following requirements shall apply to any alternative payment methodology developed by the department for payments to federally qualified health centers: (1) The alternative payment methodology must be consistent with the requirements of 42 USC 1396a(bb), as may be amended from time to time; (2) to the extent federal law requires that federally qualified health centers be allowed to elect to use the prospective payment system set forth in 42 USC 1396a(bb)(3), as amended from time to time, any alternative payment methodology developed under this section must be an additional option and not in lieu of the alternative, updated prospective payment methodology provided for in subsection (c) of this section; and (3) in developing an alternative payment methodology, the department shall consult with federally qualified health centers prior to implementing any such methodology.
(June 30 Sp. Sess. P.A. 03-3, S. 85; P.A. 07-101, S. 1; P.A. 22-118, S. 239; P.A. 25-168, S. 350.)
*Note: Section 351 of public act 25-168 is special in nature and therefore has not been codified but remains in full force and effect according to its terms.
History: June 30 Sp. Sess. P.A. 03-3 effective August 20, 2003; P.A. 07-101 allowed commissioner, to extent permitted by federal law, to reimburse a federally qualified health center for multiple medical, behavioral health or dental services provided under Medicaid program to an individual during the course of a calendar day and changed date re commissioner's report on cost-based reimbursement methodology from March 1, 2004, to January 1, 2008, effective July 1, 2007; P.A. 22-118 designated existing provisions as Subsec. (a) and therein, deleted cost-based reimbursement and authorization for reimbursement of multiple health visits in a calendar day, added reimbursement based on all-inclusive encounter rate, required multiple visits on a calendar day for same type of service or with same provider be treated as single visit for reimbursement except when patient suffers subsequent injury or illness requiring diagnosis or treatment, required reimbursement in accordance with regulations, deleted required reporting by Jan. 1, 2008, and added Subsec. (b) re nonemergency periodic dental visits, effective July 1, 2022; P.A. 25-168 added Subsecs. (c) and (d) re alternative payment methodology, effective July 1, 2025.
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Sec. 17b-245d. Information to be provided by federally qualified health centers. Adjustment of encounter rates. (a) On or before February 1, 2013, and on January first annually thereafter, each federally qualified health center shall file with the Department of Social Services the following documents for the previous state fiscal year: (1) Medicaid cost report; (2) audited financial statements; and (3) any additional information reasonably required by the department. Any federally qualified health center that does not use the state fiscal year as its fiscal year shall have six months from the completion of such health center's fiscal year to file said documents with the department.
(b) Each federally qualified health center shall provide to the Department of Social Services a copy of its original scope of project, as approved by the federal Health Resources and Services Administration, and all subsequently approved amendments to its original scope of project. Each federally qualified health center shall notify the department, in writing, of all approvals for additional amendments to its scope of project, and provide to the department a copy of such amended scope of project, not later than thirty days after such approvals.
(c) Under the payment methodologies provided under subsections (a) and (c) of section 17b-245b, the department may adjust a federally qualified health center's encounter rate based upon an increase or decrease in the scope of services furnished by the federally qualified health center, in accordance with 42 USC 1396a(bb)(3)(B), following receipt of the written notification described in this subsection or based upon the department's review of documents filed in accordance with subsections (a) and (b) of this section, and upon demonstration that the federally qualified health center's costs of providing services has experienced a change as a result of a change in the type, intensity, duration or amount of services provided in a patient encounter.
(1) If there is an increase or a decrease in the scope of services furnished by a federally qualified health center, the federally qualified health center shall notify the Department of Social Services, in writing, of any such increase or decrease not later than sixty calendar days after the end of the federally qualified health center's fiscal year in which the change in scope of services occurred and provide any additional information reasonably requested by the department not later than thirty calendar days after the department's request.
(2) Notwithstanding this section and section 17b-262 and regulations adopted thereunder, a change in the volume of services, including, but not limited to, a change in the volume of services as a result of an expansion or reduction of an existing clinic, the addition or discontinuance of a satellite or new site, a change in operational costs attributable to capital expenditures, including new service facilities or regulatory compliance, or an increase in utilization of current services, shall not constitute a change in the scope of services furnished by a federally qualified health center for which a federally qualified health center's encounter rate may be adjusted. This subdivision shall not preclude a federally qualified health center from requesting a change in scope based on a change in the type, intensity, duration or amount of services provided in a patient encounter, even if such change in the type, intensity, duration or amount of services provided in a patient encounter may have resulted from an expansion or reduction of an existing clinic or the addition or discontinuance of a satellite or new site.
(3) If the Department of Social Services approves a change in scope of services request, and contingent upon the federally qualified health center's compliance with the mandatory notice provisions provided under subdivision (1) of this subsection, the new encounter rate shall be effective on the date of the department's approval of said change in scope request or the next calendar date after the end of the federally qualified health center's fiscal year in which the change in scope occurred, whichever is earlier.
(d) The Commissioner of Social Services may impose a civil penalty of five hundred dollars per day on any federally qualified health center that fails to provide any information required pursuant to this section not later than thirty days after the date such information is due.
(e) The Commissioner of Social Services shall implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulations, or amending existing regulations, provided the commissioner publishes notice of intent to adopt regulations on the eRegulations System not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.
(Dec. Sp. Sess. P.A. 12-1, S. 10; P.A. 14-217, S. 192; P.A. 25-168, S. 352.)
History: Dec. Sp. Sess. P.A. 12-1 effective December 21, 2012; P.A. 14-217 amended Subsec. (a) by adding provision re filing deadline for federally qualified health center that does not use the state fiscal year, effective July 1, 2014; P.A. 25-168 deleted former Subsecs. (c) and (d) re change in scope of services reporting and penalty, redesignated Subsec. (e) as Subsec. (c) and therein inserted references to payment methodologies in Sec. 17b-245 and demonstration of change in cost of services, added Subdivs. (1) to (3) re change in scope of services and made conforming technical changes, added new Subsec. (d) re penalty, redesignated Subsec. (f) as Subsec. (e) and therein added reference to amending regulations, deleted provision re printing regulation notice in Connecticut Law Journal and inserted provision re publishing notice on eRegulations System, effective July 1, 2025.
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Sec. 17b-256f. Eligibility for Medicare savings programs. Regulations. (a) The Commissioner of Social Services shall increase income disregards used to determine eligibility by the Department of Social Services for the federal Qualified Medicare Beneficiary, the Specified Low-Income Medicare Beneficiary and the Qualifying Individual programs, administered in accordance with the provisions of 42 USC 1396d(p), by such amounts that shall result in persons with income that is (1) less than two hundred eleven per cent of the federal poverty level qualifying for the Qualified Medicare Beneficiary program, (2) at or above two hundred eleven per cent of the federal poverty level but less than two hundred thirty-one per cent of the federal poverty level qualifying for the Specified Low-Income Medicare Beneficiary program, and (3) at or above two hundred thirty-one per cent of the federal poverty level but less than two hundred forty-six per cent of the federal poverty level qualifying for the Qualifying Individual program.
(b) The commissioner shall not apply an asset test for eligibility under the Medicare Savings Program. The commissioner shall disregard from income all United States Department of Veterans Affairs-administered non-service-connected pension benefits, Aid and Attendance pension benefits and Housebound pension benefits that are granted to a veteran, as defined in section 27-103, or the surviving spouse of such veteran. The Commissioner of Social Services, pursuant to section 17b-10, may implement policies and procedures to administer the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided the commissioner prints notice of the intent to adopt the regulations on the department's Internet web site and the eRegulations System not later than twenty days after the date of implementation. Such policies and procedures shall be valid until the time final regulations are adopted.
(P.A. 09-2, S. 16; Sept. Sp. Sess. P.A. 09-5, S. 70; Sept. Sp. Sess. P.A. 09-7, S. 182; P.A. 11-44, S. 91; P.A. 12-1, S. 1; 12-208, S. 3; P.A. 13-234, S. 82; June Sp. Sess. P.A. 17-2, S. 50; Jan. Sp. Sess. P.A. 17-1, S. 5, 6; P.A. 18-81, S. 13; P.A. 25-95, S. 5.)
History: P.A. 09-2 effective April 1, 2009; Sept. Sp. Sess. P.A. 09-5 changed commencement date from June 30, 2009, to October 1, 2009, and added provision re asset test, effective October 5, 2009; Sept. Sp. Sess. P.A. 09-7 deleted references to fiscal year and inserted “annually”, effective October 5, 2009; P.A. 11-44 added provisions requiring commissioner to consider deductions in calculating income disregards used to determine eligibility, effective July 1, 2011; P.A. 12-1 changed commencement date from October 1, 2009, to March 1, 2012, effective March 6, 2012; P.A. 12-208 added provision re income disregard for veterans' Aid and Attendance pension benefits, effective July 1, 2012; P.A. 13-234 eliminated provision tying eligibility for Medicare Savings programs to income eligibility for the ConnPACE program, added provision establishing separate income standards and made technical changes, effective January 1, 2014; June Sp. Sess. P.A. 17-2 replaced “increase income disregards used to determine eligibility by the Department of Social Services” with “establish eligibility”, replaced “two hundred eleven per cent” with “one hundred per cent” in Subdiv. (1), replaced “two hundred eleven per cent” with “one hundred per cent” and replaced “two hundred thirty-one per cent” with “one hundred twenty per cent” in Subdiv. (2), replaced “two hundred thirty-one per cent” with “one hundred twenty per cent” and “two hundred forty-six per cent” with “one hundred thirty-five per cent” in Subdiv. (3), and replaced “in the Connecticut Law Journal” with “on the department's Internet web site and the eRegulations System”, effective January 1, 2018; Jan. Sp. Sess. P.A. 17-1 replaced “establish eligibility” with “increase income disregards used to determine eligibility by the Department of Social Services”, amended Subdiv. (1) by replacing “one hundred per cent” with “two hundred eleven per cent”, amended Subdiv. (2) by replacing “one hundred per cent” with “two hundred eleven per cent” and replacing “one hundred twenty per cent” with “two hundred thirty-one per cent”, amended Subdiv. (3) by replacing “one hundred twenty per cent” with “two hundred thirty-one per cent” and replacing “one hundred thirty-five per cent” with “two hundred forty-six per cent”, effective January 31, 2018, and replaced “increase income disregards used to determine eligibility by the Department of Social Services” with “establish eligibility”, amended Subdiv. (1) by replacing “two hundred eleven per cent” with “one hundred per cent”, amended Subdiv. (2) by replacing “two hundred eleven per cent” with “one hundred per cent” and replacing “two hundred thirty-one per cent” with “one hundred twenty per cent”, and amended Subdiv. (3) by replacing “two hundred thirty-one per cent” with “one hundred twenty per cent” and replacing “two hundred forty-six per cent” with “one hundred thirty-five per cent”, effective July 1, 2018; P.A. 18-81 replaced “establish eligibility” with “increase income disregards used to determine eligibility by the Department of Social Services”, amended Subdiv. (1) by replacing “one hundred per cent” with “two hundred eleven per cent”, amended Subdiv. (2) by replacing “one hundred per cent” with “two hundred eleven per cent” and replacing “one hundred twenty per cent” with “two hundred thirty-one per cent”, and amended Subdiv. (3) by replacing “one hundred twenty per cent” with “two hundred thirty-one per cent” and replacing “one hundred thirty-five per cent” with “two hundred forty-six per cent”, effective July 1, 2018; P.A. 25-95 designated existing provisions re increase of income disregards as Subsec. (a), designated existing provisions re prohibition against application of asset test and re authorization to implement policies and procedures as Subsec. (b) and replaced “not consider as income” with “disregard from income”, added references to all United States Department of Veterans Affairs-administered non-service-connected pension benefits and Housebound pension benefits and made a technical change therein, effective July 1, 2025, and applicable to applications filed on or after July 1, 2025.
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Sec. 17b-261. (Formerly Sec. 17-134b). Medicaid. Eligibility. Assets. Waiver from federal law. State-funded medical assistance for children regardless of immigration status. (a) Medical assistance shall be provided for any otherwise eligible person (1) whose income, including any available support from legally liable relatives and the income of the person's spouse or dependent child, is not more than one hundred fifty-nine per cent, pending approval of a federal waiver applied for pursuant to subsection (e) of this section, of the benefit amount paid to a person with no income under the temporary family assistance program, and (2) if such person is an institutionalized individual as defined in Section 1917 of the Social Security Act, 42 USC 1396p(h)(3), and has not made an assignment or transfer or other disposition of property for less than fair market value for the purpose of establishing eligibility for benefits or assistance under this section. Any such disposition shall be treated in accordance with Section 1917(c) of the Social Security Act, 42 USC 1396p(c). Any disposition of property made on behalf of an applicant or recipient or the spouse of an applicant or recipient by a guardian, conservator, person authorized to make such disposition pursuant to a power of attorney or other person so authorized by law shall be attributed to such applicant, recipient or spouse. A disposition of property ordered by a court shall be evaluated in accordance with the standards applied to any other such disposition for the purpose of determining eligibility. The commissioner shall establish the standards for eligibility for medical assistance at one hundred fifty-nine per cent of the benefit amount paid to a household of equal size with no income under the temporary family assistance program. In determining eligibility, the commissioner shall not consider as income United States Department of Veterans Affairs-administered Aid and Attendance pension benefits that are granted to a veteran, as defined in section 27-103, or the surviving spouse of such veteran. Except as provided in section 17b-277 and section 17b-292, the medical assistance program shall provide coverage to persons under the age of nineteen with household income up to one hundred ninety-six per cent of the federal poverty level without an asset limit and to persons under the age of nineteen, who qualify for coverage under Section 1931 of the Social Security Act, with household income not exceeding one hundred ninety-six per cent of the federal poverty level without an asset limit, and their parents and needy caretaker relatives, who qualify for coverage under Section 1931 of the Social Security Act, with household income not exceeding one hundred thirty-three per cent of the federal poverty level without an asset limit. Such levels shall be based on the regional differences in such benefit amount, if applicable, unless such levels based on regional differences are not in conformance with federal law. Any income in excess of the applicable amounts shall be applied as may be required by said federal law, and assistance shall be granted for the balance of the cost of authorized medical assistance. The Commissioner of Social Services shall provide applicants for assistance under this section, at the time of application, with a written statement advising them of (A) the effect of an assignment or transfer or other disposition of property on eligibility for benefits or assistance, (B) the effect that having income that exceeds the limits prescribed in this subsection will have with respect to program eligibility, and (C) the availability of, and eligibility for, services provided by the Connecticut Home Visiting System, established pursuant to section 17b-751b. For coverage dates on or after January 1, 2014, the department shall use the modified adjusted gross income financial eligibility rules set forth in Section 1902(e)(14) of the Social Security Act and the implementing regulations to determine eligibility for HUSKY A, HUSKY B and HUSKY D applicants, as defined in section 17b-290. To the extent permissible under federal law, the Commissioner of Social Services shall disregard all United States Department of Veterans Affairs-administered non-service-connected pension benefits, Aid and Attendance pension benefits and Housebound pension benefits that are granted to a veteran or the surviving spouse of such veteran when determining income eligibility for HUSKY A and HUSKY D applicants. Persons who are determined ineligible for assistance pursuant to this section shall be provided a written statement notifying such persons of their ineligibility and advising such persons of their potential eligibility for one of the other insurance affordability programs as defined in 42 CFR 435.4.
(b) For the purposes of the Medicaid program, the Commissioner of Social Services shall consider parental income and resources as available to a child under eighteen years of age who is living with his or her parents and is blind or disabled for purposes of the Medicaid program, or to any other child under twenty-one years of age who is living with his or her parents.
(c) For the purposes of determining eligibility for the Medicaid program, an available asset is one that is actually available to the applicant or one that the applicant has the legal right, authority or power to obtain or to have applied for the applicant's general or medical support. If the terms of a trust provide for the support of an applicant, the refusal of a trustee to make a distribution from the trust does not render the trust an unavailable asset. Notwithstanding the provisions of this subsection, the availability of funds in a trust or similar instrument funded in whole or in part by the applicant or the applicant's spouse shall be determined pursuant to the Omnibus Budget Reconciliation Act of 1993, 42 USC 1396p. The provisions of this subsection shall not apply to a special needs trust, as defined in 42 USC 1396p(d)(4)(A), as amended from time to time. For purposes of determining whether a beneficiary under a special needs trust, who has not received a disability determination from the Social Security Administration, is disabled, as defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or the commissioner's designee, shall independently make such determination. The commissioner shall not require such beneficiary to apply for Social Security disability benefits or obtain a disability determination from the Social Security Administration for purposes of determining whether the beneficiary is disabled.
(d) The transfer of an asset in exchange for other valuable consideration shall be allowable to the extent the value of the other valuable consideration is equal to or greater than the value of the asset transferred.
(e) The Commissioner of Social Services shall seek a waiver from federal law to permit federal financial participation for Medicaid expenditures for families with incomes of one hundred forty-three per cent of the temporary family assistance program payment standard.
(f) To the extent permitted by federal law, Medicaid eligibility shall be extended for one year to a family that becomes ineligible for medical assistance under Section 1931 of the Social Security Act due to income from employment by one of its members who is a caretaker relative or due to receipt of child support income. A family receiving extended benefits on July 1, 2005, shall receive the balance of such extended benefits, provided no such family shall receive more than twelve additional months of such benefits.
(g) An institutionalized spouse applying for Medicaid and having a spouse living in the community shall be required, to the maximum extent permitted by law, to divert income to such community spouse in order to raise the community spouse's income to the level of the minimum monthly needs allowance, as described in Section 1924 of the Social Security Act. Such diversion of income shall occur before the community spouse is allowed to retain assets in excess of the community spouse protected amount described in Section 1924 of the Social Security Act. The Commissioner of Social Services, pursuant to section 17b-10, may implement the provisions of this subsection while in the process of adopting regulations, provided the commissioner prints notice of intent to adopt the regulations in the Connecticut Law Journal within twenty days of adopting such policy. Such policy shall be valid until the time final regulations are effective.
(h) To the extent permissible under federal law, an institutionalized individual, as defined in Section 1917 of the Social Security Act, 42 USC 1396p(h)(3), shall not be determined ineligible for Medicaid solely on the basis of the cash value of a life insurance policy worth less than ten thousand dollars provided the individual is pursuing the surrender of the policy.
(i) Medical assistance shall be provided, in accordance with the provisions of subsection (e) of section 17a-6, to any child under the supervision of the Commissioner of Children and Families who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for such benefits. Medical assistance shall also be provided to any child in the children's services program operated by the Department of Developmental Services who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for benefits. To the extent practicable, the Commissioner of Children and Families and the Commissioner of Developmental Services shall apply for, or assist such child in qualifying for, the Medicaid program.
(j) The Commissioner of Social Services shall provide Early and Periodic Screening, Diagnostic and Treatment program services, as required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal regulations, to all persons who are under the age of twenty-one and otherwise eligible for medical assistance under this section.
(k) A veteran, as defined in section 27-103, and any member of his or her family, who applies for or receives assistance under the Medicaid program, shall apply for all benefits for which he or she may be eligible through the United States Department of Veterans Affairs or the United States Department of Defense.
(l) On and after January 1, 2023, and until June 30, 2024, the Commissioner of Social Services shall, within available appropriations, provide state-funded medical assistance to any child twelve years of age and younger, regardless of immigration status, (1) whose household income does not exceed two hundred one per cent of the federal poverty level without an asset limit, and (2) who does not otherwise qualify for Medicaid, the Children's Health Insurance Program, or an offer of affordable, employer-sponsored insurance, as defined in the Affordable Care Act, as an employee or a dependent of an employee. On and after July 1, 2024, the commissioner shall, within available appropriations, provide state-funded medical assistance to any child fifteen years of age and younger, regardless of immigration status, who qualifies pursuant to subdivisions (1) and (2) of this subsection. A child eligible for such assistance under this subsection shall continue to receive such assistance until such child is nineteen years of age, provided the child continues to meet the eligibility requirements prescribed in subdivisions (1) and (2) of this subsection. The provisions of section 17b-265 shall apply with respect to any medical assistance provided pursuant to this subsection.
(1967, P.A. 759, S. 1(b); 1969, P.A. 730, S. 8; P.A. 78-192, S. 4, 7; P.A. 80-50; P.A. 81-214, S. 6; P.A. 85-505, S. 14, 21; 85-527; P.A. 86-363, S. 3; P.A. 87-390, S. 1, 4; P.A. 89-317, S. 1, 2; P.A. 92-233, S. 1; P.A. 93-262, S. 1, 87; 93-289, S. 1-3; 93-435, S. 59, 95; May Sp. Sess. P.A. 94-5, S. 16, 30; P.A. 95-194, S. 30, 33; 95-351, S. 22, 30; P.A. 96-251, S. 9; P.A. 97-288, S. 3, 6; June 18 Sp. Sess. P.A. 97-2, S. 70, 165; Oct. 29 Sp. Sess. P.A. 97-1, S. 19, 23; P.A. 99-279, S. 16, 45; June Sp. Sess. P.A. 00-2, S. 18, 53; June Sp. Sess. P.A. 01-2, S. 3, 69; June Sp. Sess. P.A. 01-9, S. 129, 131; P.A. 03-2, S. 10; 03-28, S. 2; 03-268, S. 7; June 30 Sp. Sess. P.A. 03-3, S. 63; P.A. 04-16, S. 6; P.A. 05-1, S. 1; 05-24, S. 1; 05-43, S. 1; 05-280, S. 1; P.A. 06-164, S. 3; 06-188, S. 49; 06-196, S. 134, 238, 289; P.A. 07-185, S. 3; June Sp. Sess. P.A. 07-2, S. 7; P.A. 09-8, S. 3; 09-66, S. 1; P.A. 10-179, S. 66; P.A. 11-176, S. 3; P.A. 12-208, S. 5; June 12 Sp. Sess. P.A. 12-1, S. 8; P.A. 13-234, S. 127; P.A. 15-69, S. 17; June Sp. Sess. P.A. 15-5, S. 358, 370; P.A. 16-12, S. 1; 16-176, S. 1; June Sp. Sess. P.A. 17-2, S. 138; P.A. 18-72, S. 29; 18-81, S. 48; P.A. 19-117, S. 316; P.A. 21-172, S. 13; 21-176, S. 1; P.A. 22-118, S. 232, 237; P.A. 23-204, S. 283; P.A. 24-81, S. 38; P.A. 25-39, S. 15; 25-79, S. 9; 25-95, S. 6.)
History: 1969 act deleted varying income limits and exclusions dependent upon marital status and number of dependents, referring instead to income limits under federal law; P.A. 78-192 added provisions re increases in eligibility standards; P.A. 80-50 added Subsec. (b); P.A. 81-214 added provisions re effect of transfer of property on eligibility for benefits in Subsec. (a); P.A. 85-505 amended Subsec. (a) to allow the extension of benefits for 6 months for former recipients; P.A. 85-527 amended Subsec. (a) by replacing “the minimum income permissible under federal law” with 120% “of the standard of need”; P.A. 86-363 included children under 18 years of age who are living with their parents and are blind or disabled in group for which parental income shall be considered under Subsec. (b); P.A. 87-390 changed the limit from 120% to 133%, added language on division of property and transfer of the interest in a house between spouses, and added requirement for a written statement advising applicants of the effect of an assignment, transfer or other disposition of property on eligibility; P.A. 89-317 amended Subsec. (a) to require that a person be institutionalized, as defined in the Social Security Act, to be eligible for medical assistance, changed the time from which a transfer of assets will be permitted from 24 months to 30 months prior to the date of application and 30 months prior to the date of institutionalization and to require treatment of any disposition of assets in accordance with Section 1917 (c) of the Social Security Act, 42 U.S.C. 1396p (c); P.A. 92-233 amended Subsec. (a) by adding provisions re attribution of property disposed of on behalf of an applicant or his spouse by a guardian, conservator or authorized representative and disposition of property ordered by a court; P.A. 93-262 and P.A. 93-435 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; P.A. 93-289, S. 1, required that the medical assistance program provide coverage to persons under the age of 6 and S. 2 was added editorially by the Revisors as Subsec. (c) requiring the department of income maintenance to submit a report, effective July 1, 1993; May Sp. Sess. P.A. 94-5 removed the time limit on transfers of assets and extended coverage to children under the age of 19 born after September 30, 1983, rather than children under 6, effective July 1, 1994; Sec. 17-134b transferred to Sec. 17b-261 in 1995; P.A. 95-194 amended Subsec. (a) by changing the eligibility for medical assistance from an income which is not more than 133% of the standard of need established pursuant to Sec. 17b-104 to an income which is not more than 142% of the benefit amount paid to a person with no income under the AFDC program in the appropriate region of residence and by requiring the commissioner to establish the standards for eligibility for medical assistance at 133% of the benefit amount paid to a family unit of equal size with no income under the AFDC program in the appropriate region of residence, added Subdiv. (d) requiring the commissioner to seek a waiver to permit federal financial participation for Medicaid expenditures and made technical changes, effective July 1, 1995; P.A. 95-351 replaced 142% with 143% as the highest allowable percentage of income for the provision of medical assistance and made a technical change, effective July 1, 1995; P.A. 96-251 amended Subsec. (c) by requiring that on and after October 1, 1996, reports be submitted to the legislative committee on human services and to legislators upon request and by adding provisions re submission of report summaries to legislators; P.A. 97-288 amended Subsec. (a) to require that contracts entered into after July 1, 1997, include provisions for collaboration of managed care organizations with the program established under Sec. 17a-56, effective July 1, 1997; June 18 Sp. Sess. P.A. 97-2 amended Subsec. (a) by extending Medicaid coverage, on and after July 1, 1998, from persons under the age of 19 born after September 30, 1983, to persons under the age of 19 born after September 30, 1981, or if possible, within available appropriations, born after June 30, 1980, with family income up to 185% of the federal poverty level without an asset limit, replaced references to aid to families with dependent children with temporary family assistance, and made technical and conforming changes, effective July 1, 1997; Oct. 29 Sp. Sess. P.A. 97-1 amended Subsec. (a) to provide that on and after January 1, 1998, the medical assistance program shall provide coverage to persons under the age of 19 and deleted reference to “born after June 30, 1981, or if possible within available appropriations, born after June 30, 1980”, effective October 30, 1997; P.A. 99-279 amended Subsec. (a) to require extension of coverage under the medical assistance program to parents of children enrolled in the HUSKY Plan, Part A and to their needy caretaker relatives who qualify for coverage under Section 1931 of the Social Security Act and made technical changes, effective July 1, 2000; June Sp. Sess. P.A. 00-2 amended Subsec. (a) by deleting “born after September 30, 1981,” changing “July 1, 2000,” to “January 1, 2001,” changing the family income level for eligibility for medical assistance from 185% to 150% of federal poverty level, and adding provision re providing coverage upon the request of a person or upon a redetermination of eligibility, effective July 1, 2000; June Sp. Sess. P.A. 01-2 made technical changes for purposes of gender neutrality in Subsec. (b), added new Subsecs. (c) and (d) re availability and transfer of assets, and redesignated existing Subsecs. (c) and (d) as Subsecs. (e) and (f), effective July 1, 2001; June Sp. Sess. P.A. 01-9 revised effective date of June Sp. Sess. P.A. 01-2 but without affecting this section; P.A. 03-2 amended Subsec. (a) by making a technical change and changing family income eligibility limit for parents and needy caretaker relatives who qualify for medical assistance program coverage under Section 1931 of the Social Security Act from 150% of the federal poverty limit to 100% of the federal poverty limit, and added new Subsec. (g), redesignated by the Revisors as new Subsec. (f), re ineligibility on or after April 1, 2003, of all parent and needy caretaker relatives with incomes exceeding 100% of the federal poverty level, effective February 28, 2003; P.A. 03-28 added new Subsec. (g) re extended Medicaid eligibility; P.A. 03-268 deleted former Subsec. (e) re submission of annual report to General Assembly re children receiving Medicaid services and doctors and dentists participating in state or municipally-funded programs and redesignated existing Subsec. (f) as Subsec. (e); June 30 Sp. Sess. P.A. 03-3 added new Subsec. (h) requiring an institutionalized spouse applying for Medicaid, who has a spouse living in the community, to divert income to the community spouse so as to raise the community spouse's income to the level of the minimum monthly needs allowance described in Section 1924 of the Social Security Act, effective August 20, 2003; P.A. 04-16 amended Subsec. (g) by adding “one of its members who is a caretaker relative is” re extended Medicaid eligibility and making a technical change; P.A. 05-1 added Subsec. (i) which extended transitional Medicaid benefits until June 30, 2005, for certain individuals who were to lose coverage between March 31, 2005, and May 31, 2005, effective March 10, 2005; P.A. 05-24 added new Subsec. (i) re provision of Medicaid coverage to a child under the supervision of the Commissioner of Children and Families, effective July 1, 2005; P.A. 05-43 amended Subsec. (g) by eliminating “or a family with an adult who, within 6 months of becoming ineligible under Section 1931 of the Social Security Act becomes employed”, effective July 1, 2005; P.A. 05-280 amended Subsec. (a) by increasing family income limit re eligibility determinations for medical assistance for parents and needy caretakers of persons under the age of 19 from 100% to 150% of federal poverty level, deleted former Subsec. (f) re ineligibility for medical assistance for parents and needy caretaker relatives with incomes exceeding 100% of federal poverty level, redesignated Subsecs. (g) and (h) as Subsecs. (f) and (g), amended redesignated Subsec. (f) to reduce period of transitional medical assistance from 2 years to 1 year, add provision re extension of assistance to family that becomes ineligible “due to income from employment by” one of its members and provide that family receiving extended benefits “shall receive the balance of such extended benefits, provided no such family shall receive more than 12 additional months of such benefits”, deleted former Subsec. (i) which had extended transitional medical assistance to June 30, 2005, for certain individuals and added new Subsec. (h) re cost sharing requirements under the HUSKY Plan, effective July 1, 2005; P.A. 06-164 amended Subsec. (a) to substitute “Nurturing Families Network” for “Healthy Families Connecticut Program”, insert Subdiv. (1) designator and insert Subdiv. (2) re written statement on services provided by the Nurturing Families Network, effective July 1, 2006; P.A. 06-188 added Subsec. (j) re requirement to provide Early and Periodic Screening, Diagnostic and Treatment program services, as required by federal law, to persons under age 21 who are otherwise eligible for medical assistance, effective July 1, 2006; P.A. 06-196 made a technical change in Subsecs. (a) and (f), effective June 7, 2006, and inserted “and defined as of December 31, 2005,” and made a technical change in Subsec. (j), effective July 1, 2006; P.A. 07-185 amended Subsec. (a) by increasing, except as provided in Sec. 17b-277, family income limits used to determine eligibility for medical assistance for parents and needy caretaker relatives of persons under the age of 19 from 150% of federal poverty level to 185% of federal poverty level, by providing that commissioner shall advise applicants in writing of effect that having income in excess of program limits will have with respect to program eligibility and availability of HUSKY Plan, Part B benefits for persons determined not eligible for medical assistance, and by making conforming changes, effective July 1, 2007; June Sp. Sess. P.A. 07-2 amended Subsec. (a) by requiring that medical assistance coverage be provided to persons under 19 with family income up to 185% of federal poverty level without an asset limit, by deleting provision requiring that commissioner, at the time application for assistance is made, provide a written statement re availability of HUSKY Plan, Part B, health insurance benefits to persons not eligible for assistance, and by adding provision requiring that commissioner provide written statement at the time a person is determined ineligible for assistance, deleted former Subsec. (h) re commissioner's authority to impose cost sharing requirements on parents and needy caretakers with incomes in excess of 100% of federal poverty level, and redesignated existing Subsecs. (i) and (j) as Subsecs. (h) and (i), effective July 1, 2007; P.A. 09-8 made technical changes in Subsec. (a); P.A. 09-66 amended Subsec. (h) by deleting “because of institutional status” and adding provisions re medical assistance to be provided to children in Department of Developmental Services' voluntary services program who are not receiving Medicaid benefits, effective July 1, 2009; P.A. 10-179 amended Subsec. (a) by deleting provision requiring contracts to include provisions for collaboration of managed care organizations with the Nurturing Families Network, effective July 1, 2010; P.A. 11-176 amended Subsec. (c) by adding provisions re determining whether a beneficiary under a special needs trust is disabled, effective July 13, 2011; P.A. 12-208 amended Subsec. (a) to add provision re income disregard for veterans' Aid and Attendance pension benefits, effective July 1, 2012; June 12 Sp. Sess. P.A. 12-1 added Subsec. (j) re responsibility of veteran to apply for benefits through the Veterans' Administration or Department of Defense, effective July 1, 2012; P.A. 13-234 amended Subsec. (a) to change federal statutory citations, added new Subsec. (h) re conditions under which Medicaid eligibility will be granted for persons with certain life insurance policies and redesignated existing Subsecs. (h), (i) and (j) as Subsecs. (i), (j) and (k); P.A. 15-69 amended Subsec. (a) to change “family” to “household”, add reference to Sec. 17b-292, increase income eligibility from 185 per cent to 196 per cent of federal poverty level, add provision re use of modified adjusted gross income financial eligibility rules and add provision re ineligible individuals to be notified of potential eligibility for other programs as defined in 42 CFR 435.4, rather than availability of HUSKY Plan, Part B, effective June 19, 2015; June Sp. Sess. P.A. 15-5 amended Subsec. (i) to replace “voluntary” with “behavioral” re services program, effective July 1, 2015, and amended Subsec. (a) to add provisions re decrease of income limit for parents and needy caretaker relatives from 196 per cent to 150 per cent of federal poverty level and make technical changes, effective August 1, 2015; P.A. 16-12 amended Subsec. (h) to delete former Subdiv. (2) re proceeds of surrendered policy to be used to pay for long-term care and delete Subdiv. (1) designator, effective May 6, 2016; P.A. 16-176 amended Subsec. (c) to add “, as amended from time to time” re references to 42 USC 1396p(d)(4)(A), effective June 6, 2016; June Sp. Sess. P.A. 17-2 amended Subsec. (a) by replacing 150 per cent with 133 per cent re household income for parents and needy caretaker relatives, effective January 1, 2018; P.A. 18-72 amended Subsec. (k) to replace “Veterans' Administration” with “United States Department of Veterans Affairs”; P.A. 18-81 amended Subsec. (a) by increasing maximum household income for parents and needy caretaker relatives eligible under Section 1931 of the Social Security Act from 133 per cent of the federal poverty level to 150 per cent of the federal poverty level, effective July 1, 2018; P.A. 19-117 amended Subsec. (a) by increasing maximum income eligibility for parents and needy caretaker relatives from 150 per cent to 155 per cent of the federal poverty level; P.A. 21-172 amended Subsec. (a)(3) by replacing “Nurturing Families Network” with “Connecticut Home Visiting System”, effective July 1, 2021; P.A. 21-176 added Subsec. (l) re coverage of children regardless of immigration status; P.A. 22-118 amended Subsec. (a) by removing regional temporary family assistance benefit standards in the calculation of medical assistance income eligibility, added new subdivision designators (1) and (2) and redesignated existing Subdivs. (1) to (3) as Subparas. (A) to (C), effective July 1, 2022, and amended Subsec. (l) by increasing the age of children eligible for state-funded medical assistance from 8 to 12 years regardless of immigration status and allowing such eligible children to retain such assistance until age 19, effective May 7, 2022; P.A. 23-204 amended Subsec. (l) by authorizing coverage for eligible children up to age 15 on and after July 1, 2024, subject to the provisions of Sec. 17b-265, effective June 12, 2023; P.A. 24-81 amended Subsec. (a) by increasing HUSKY C income eligibility cap from 143 per cent to 159 per cent of the temporary family assistance benefit level for persons with no income and reducing income eligibility cap for certain parents and caretaker relatives of HUSKY A beneficiaries from 155 per cent to 133 per cent of the federal poverty level; P.A. 25-39 made a technical change in Subsec. (a); P.A. 25-79 amended Subsec. (i) by replacing “behavioral services program” with “children's services program”; P.A. 25-95 made an identical technical change as P.A. 25-39 and further amended Subsec. (a) by adding “United States Department of Veterans Affairs-administered” before “Aid and Attendance pension benefits”, adding provision re disregard of all United States Department of Veterans Affairs-administered pension benefits when determining income eligibility for HUSKY A and HUSKY D applicants and making a technical change, effective July 1, 2025, and applicable to applications filed on or after July 1, 2025.
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Sec. 17b-261f. Mobile field hospital account. There is established a mobile field hospital account, which shall be a separate, nonlapsing account. Moneys in the account shall be used by the Department of Social Services to fund the operations of the mobile field hospital in the event of an activation. The account shall contain all moneys required by law to be deposited in the account.
(P.A. 05-280, S. 62; P.A. 07-252, S. 64; P.A. 25-110, S. 66.)
History: P.A. 05-280 effective July 1, 2005; P.A. 07-252 substituted “mobile field hospital account” for “critical access hospital account” and “mobile field hospital” for “critical access hospital”, effective July 12, 2007; P.A. 25-110 deleted reference to General Fund and made a technical change, effective July 1, 2025.
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Sec. 17b-278l. Medical assistance for obesity treatment, surgery. Definitions. State plan amendments, reporting on glucagon-like peptide (GLP-1) drug coverage. (a)(1) As used in this section, “bariatric surgery” means surgical changes to the digestive system to help a patient with obesity to lose weight;
(2) “Body mass index” means the number calculated by dividing an individual's weight in kilograms by the individual's height in meters squared;
(3) “Medical services” means (A) prescription drugs approved by the federal Food and Drug Administration for the treatment of obesity on an outpatient basis for individuals with type 2 diabetes and prescription drugs approved by the federal Food and Drug Administration on an outpatient basis for the treatment of a comorbid condition for individuals with obesity, subject to prior authorization and only after step therapy when clinically appropriate, and (B) nutritional counseling provided by a registered dietitian-nutritionist certified pursuant to section 20-206n;
(4) “Severe obesity” means a body mass index that is:
(A) Greater than forty; or
(B) Thirty-five or more if an individual has been diagnosed with a comorbid disease or condition, including, but not limited to, a cardiopulmonary condition, diabetes, hypertension or sleep apnea; and
(5) “Obesity” means a body mass index of thirty or higher.
(b) The Commissioner of Social Services may amend the Medicaid state plan and the state plan for the Children's Health Insurance Program to provide for this optional coverage under such programs, in accordance with federal law, for (1) bariatric surgery and related medical services for Medicaid and HUSKY B beneficiaries with severe obesity, and (2) medical services for Medicaid and HUSKY B beneficiaries with a body mass index greater than thirty-five, provided such beneficiaries otherwise meet conditions set by the Centers for Medicare and Medicaid Services for such surgery and medical services. Upon approval of any state plan amendment, the Department of Social Services shall provide said coverage.
(c) Notwithstanding the provisions of subsection (b) of section 17b-274f, any step therapy that may be required by the Commissioner of Social Services pursuant to the provisions of this section may be for a period of time not longer than one hundred eighty days.
(d) Notwithstanding subsections (b) and (c) of this section, step therapy shall not be required to obtain Medicaid coverage for medications approved in the state plan amendment to treat obesity for those individuals with a body mass index of forty or higher who a licensed health care provider certifies in writing are scheduled to undergo surgery requiring anesthesia not later than six months after such certification.
(e) The Commissioner of Social Services shall collect data concerning the use by Medicaid beneficiaries of glucagon-like peptide (GLP-1) drugs and costs and benefits to the state. Not later than January 15, 2026, and annually thereafter, the commissioner shall submit a report, in accordance with the provisions of section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies, human services and public health on: (1) The number of Medicaid recipients who received GLP-1 drug treatment in the last calendar year, (2) the number of Medicaid recipients prescribed such drugs primarily due to a type 2 diabetes diagnosis, (3) the number of Medicaid recipients prescribed such drugs primarily due to cardiovascular concerns, (4) the total cost to the state to provide Medicaid coverage of such drugs, and (5) the total amount of rebates or discounts received from pharmaceutical companies associated with inclusion of such drugs in the Medicaid program to the extent permissible.
(f) Not later than thirty days after July 8, 2025, the Commissioner of Social Services shall petition the Secretary of the Department of Health and Human Services pursuant to 28 USC 1498, as amended from time to time, to authorize generic, lower cost forms of glucagon-like peptide (GLP-1) prescription drugs approved by the federal Food and Drug Administration to treat obesity or diabetes.
(g) Upon approval of such petition, the commissioner may enter into a contract with any manufacturer of generic forms of such drugs approved by the federal Food and Drug Administration to supply such drugs to the state for use by HUSKY Health program members. The commissioner may enter into a consortium with officials in other states in contracting with such manufacturer for such drugs.
(P.A. 23-94, S. 1; P.A. 24-35, S. 4; P.A. 25-167, S. 22; 25-168, S. 327, 328.)
History: P.A. 23-94 effective July 1, 2023; P.A. 24-35 made a technical change in Subsec. (a)(3), effective May 21, 2024; P.A. 25-167, S. 22, re federal petition and contracts for generic glucagon-like peptide (GLP-1) prescription drugs was added editorially by the Revisors as Subsecs. (f) and (g), effective July 8, 2025; P.A. 25-168, S. 328, re reporting on glucagon-like peptide (GLP-1) drug coverage was added editorially by the Revisors as Subsec. (e), effective June 30, 2025, and S. 327 amended Subsec. (a)(3)(A) by inserting provisions re individuals, diseases and conditions drugs must be federally approved for and requiring step therapy and prior authorization, amended Subsec. (b) by deleting mandatory coverage requirement, deleting provision re commissioner authority to amend state plans and replacing it with language authorizing such amendments, inserting provision describing such coverage as optional and requiring state plan amendments be approved before coverage begins and added Subsecs. (c) and (d) re step therapy requirements, effective July 1, 2025.
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Sec. 17b-278o. Medicaid coverage for sickle cell disease gene therapies. (a) The Commissioner of Social Services shall provide Medicaid coverage for gene therapies approved by the federal Food and Drug Administration to treat sickle cell disease.
(b) The commissioner shall apply for any federal initiative to increase cost-effective access to the therapies, including, but not limited to, the Cell and Gene Therapy Access Model administered by the Centers for Medicare and Medicaid Services.
(c) Not later than January 1, 2026, the commissioner shall file a report, in accordance with the provisions of section 11-4a, with the joint standing committee of the General Assembly having cognizance of matters relating to human services on the (1) efforts to increase cost-effective access to the therapies, (2) number of Medicaid recipients who have received Medicaid coverage for the therapies, (3) cost to the state to provide such therapies, and (4) estimated state appropriations needed to provide such coverage.
(P.A. 25-63, S. 1.)
History: P.A. 25-63 effective June 23, 2025.
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Sec. 17b-281d. Information dissemination concerning coverage for custom-made, noninvasive breast prostheses. As used in this section, “custom-made, noninvasive breast prosthesis” means an exterior, custom-made form to fit the individual physical profile of a mastectomy patient to restore such patient's symmetrical appearance after surgery. The Commissioner of Social Services shall (1) develop and distribute to Medicaid-enrolled providers a bulletin concerning Medicaid coverage for a custom-made, noninvasive breast prosthesis, (2) include information on such coverage in communication materials to persons enrolled in the Medicaid program, and (3) in collaboration with the Commissioner of Public Health, disseminate information regarding coverage through existing programs.
(P.A. 25-168, S. 341.)
History: P.A. 25-168 effective June 30, 2025.
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Sec. 17b-283. (Formerly Sec. 17-134ee). Medicaid home and community-based services waiver program for children and young adults with disabilities. The Commissioner of Social Services shall, within available appropriations, administer a Medicaid waiver program pursuant to Section 1915(c) of the Social Security Act to provide home and community-based services for persons who are institutionalized or at risk of institutionalization and who (1) are eighteen years of age or younger; (2) have a physical disability and may also have a co-occurring developmental disability; and (3) meet the financial eligibility criteria established in the waiver.
(P.A. 90-134, S. 5, 28; P.A. 93-262, S. 1, 87; June 18 Sp. Sess. P.A. 97-2, S. 74, 165; June Sp. Sess. P.A. 00-2, S. 50, 53; P.A. 12-119, S. 2; P.A. 25-42, S. 1.)
History: P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-134ee transferred to Sec. 17b-283 in 1995; June 18 Sp. Sess. P.A. 97-2 made a technical and conforming change in Subsec. (b), effective July 1, 1997; June Sp. Sess. P.A. 00-2 deleted former Subsec. (b) re feasibility study concerning Medicaid coverage for outpatient substance abuse treatment, removed Subsec. (a) designator and added language re amendment of waiver to increase number of eligible persons, effective July 1, 2000; P.A. 12-119 replaced former provisions re model 2176 Medicaid waiver with provisions re Medicaid waiver program for certain children and young adults with disabilities, effective July 1, 2012; P.A. 25-42 decreased eligibility age from 21 to 18 years or younger, effective July 1, 2025.
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Sec. 17b-283b. Katie Beckett Waiver Program. Dissemination of information on program, related resources, provider rates. Annual survey of applicants on waiting list. (a) For purposes of this section and section 3 of public act 25-42*, the “Katie Beckett Waiver Program” means the Medicaid waiver program established pursuant to section 17b-283. Not later than January 1, 2026, the Commissioner of Social Services shall make available on the Internet web site of the Department of Social Services:
(1) Information on eligibility criteria for the Katie Beckett Waiver Program, including any income or asset thresholds;
(2) A summary of services available under the program;
(3) A listing with contact information for family support groups and advocacy groups for children and young adults with severe debilitating diseases or conditions;
(4) A listing of other Medicaid waiver programs or Medicaid state plan services that offer services for such children and young adults, including eligibility criteria for such programs; and
(5) A listing of private organizations and state programs that may offer funding for home modification or adaptive equipment for persons with disabilities, including a link to the Internet web site of the Department of Aging and Disability Services for information on adaptive equipment purchases pursuant to section 17a-788 or assistive technology loans pursuant to section 17a-795.
(b) The Commissioner of Social Services shall include information on eligibility criteria and provider reimbursement rates for the Katie Beckett Waiver Program in Medicaid provider bulletins.
(c) The Commissioner of Social Services shall annually administer a survey via electronic mail or mail to applicants who are on the waiting list for the Katie Beckett Waiver Program. The survey shall be designed to allow applicants to confirm or update demographic information and choose to remain on the waiting list or be removed. Applicants who do not respond shall remain on the waiting list.
(P.A. 25-42, S. 2.)
*Note: Section 3 of public act 25-42 is special in nature and therefore has not been codified but remains in full force and effect according to its terms.
History: P.A. 25-42 effective June 10, 2025.
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Sec. 17b-288. Organ transplant account. Regulations. (a) There is established an organ transplant account, which shall be a separate, nonlapsing account. Any moneys collected under the contribution system established under section 12-743 shall be deposited by the Commissioner of Revenue Services into the account. This account may also receive moneys from public and private sources or from the federal government. All moneys deposited in the account shall be used by the Department of Social Services or persons acting under a contract with the department, (1) to assist residents of the state in paying all or part of any costs associated with a medically required organ transplant, (2) to assist individuals who have donated an organ to a resident of the state in paying all or part of any costs associated with the organ donation, including, but not limited to, costs of transportation, accommodation and lost wages, or (3) for the promotion of the income tax contribution system and the organ transplant account. Expenditures from the account in any fiscal year for the promotion of the contribution system or the account shall not exceed ten per cent of the amount of moneys raised during the previous fiscal year, provided such limitation shall not apply to an expenditure of not more than fifteen thousand dollars from the account on or before July 1, 1994, to reimburse expenditures made on or before said date, with prior written authorization of the Commissioner of Public Health, by private organizations to promote the contribution system and the organ transplant account.
(b) The Commissioner of Social Services shall adopt regulations, in accordance with the provisions of chapter 54, to provide for the distribution of funds available pursuant to this section and section 12-743.
(P.A. 93-233, S. 2; 93-381, S. 9, 39; 93-435, S. 59, 95; P.A. 94-175, S. 15, 32; 94-210, S. 25, 30; May Sp. Sess. P.A. 94-4, S. 80, 85; P.A. 95-160, S. 64, 69; 95-257, S. 12, 21, 58; P.A. 08-184, S. 52; P.A. 25-110, S. 67.)
History: P.A. 93-381 and P.A. 93-435 authorized substitution of commissioner and department of public health and addiction services for commissioner and department of health services, effective July 1, 1993; P.A. 94-175 in Subsec. (a) changed account name from “organ transplant fund account” to “organ transplant account”, effective June 2, 1994; P.A. 94-210 transferred responsibility for the program from the department of public health and addiction services to the department of social services, effective July 1, 1994; May Sp. Sess. P.A. 94-4 and P.A. 95-160 revised effective date of P.A. 94-175 but without affecting this section; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 08-184 amended Subsec. (a) by adding new Subdiv. (2) re providing assistance to individuals who have donated organ to a state resident by paying certain costs associated with the donation and redesignating existing Subdiv. (2) as Subdiv. (3), effective July 1, 2008; P.A. 25-110 amended Subsec. (a) by deleting reference to General Fund and making technical changes, effective July 1, 2025.
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