Sec. 19a-754a. Office of Health Strategy established.
Sec. 19a-754e. Health care expansion study. Report.
Sec. 19a-754a. Office of Health Strategy established. (a) There is established an Office of Health Strategy, which shall be within the Department of Public Health for administrative purposes only. The department head of said office shall be the Commissioner of Health Strategy, who shall be appointed by the Governor in accordance with the provisions of sections 4-5 to 4-8, inclusive, with the powers and duties therein prescribed.
(b) The Office of Health Strategy shall be responsible for the following:
(1) Developing and implementing a comprehensive and cohesive health care vision for the state, including, but not limited to, a coordinated state health care cost containment strategy;
(2) Promoting effective health planning and the provision of quality health care in the state in a manner that ensures access for all state residents to cost-effective health care services, avoids the duplication of such services and improves the availability and financial stability of such services throughout the state;
(3) Directing and overseeing the State Innovation Model Initiative and related successor initiatives;
(4) (A) Coordinating the state's health information technology initiatives, (B) seeking funding for and overseeing the planning, implementation and development of policies and procedures for the administration of the all-payer claims database program established under section 19a-775a, (C) establishing and maintaining a consumer health information Internet web site under section 19a-755b, and (D) designating an unclassified individual from the office to perform the duties of a health information technology officer as set forth in sections 17b-59f and 17b-59g;
(5) Directing and overseeing the Health Systems Planning Unit established under section 19a-612 and all of its duties and responsibilities as set forth in chapter 368z;
(6) Convening forums and meetings with state government and external stakeholders, including, but not limited to, the Connecticut Health Insurance Exchange, to discuss health care issues designed to develop effective health care cost and quality strategies;
(7) Consulting with the Commissioner of Social Services, Insurance Commissioner and Connecticut Health Insurance Exchange on the Covered Connecticut program described in section 19a-754c;
(8) (A) Setting an annual health care cost growth benchmark and primary care spending target pursuant to section 19a-754g, (B) developing and adopting health care quality benchmarks pursuant to section 19a-754g, (C) developing strategies, in consultation with stakeholders, to meet such benchmarks and targets developed pursuant to section 19a-754g, (D) enhancing the transparency of provider entities, as defined in subdivision (13) of section 19a-754f, (E) monitoring the development of accountable care organizations and patient-centered medical homes in the state, and (F) monitoring the adoption of alternative payment methodologies in the state; and
(9) Assist local and regional boards of education in enrolling paraeducators for coverage under (A) the Covered Connecticut program, established pursuant to section 19a-754c, or (B) Medicaid.
(c) The Office of Health Strategy shall constitute a successor, in accordance with the provisions of sections 4-38d, 4-38e and 4-39, to the functions, powers and duties of the following:
(1) The Connecticut Health Insurance Exchange, established pursuant to section 38a-1081, relating to the administration of the all-payer claims database pursuant to section 19a-755a; and
(2) The Office of the Lieutenant Governor, relating to the (A) development of a chronic disease plan pursuant to section 19a-6q, (B) housing, chairing and staffing of the Health Care Cabinet pursuant to section 19a-725, and (C) (i) appointment of the health information technology officer, and (ii) oversight of the duties of such health information technology officer as set forth in sections 17b-59f and 17b-59g.
(d) Any order or regulation of the entities listed in subdivisions (1) and (2) of subsection (c) of this section that is in force on July 1, 2018, shall continue in force and effect as an order or regulation until amended, repealed or superseded pursuant to law.
(June Sp. Sess. P.A. 17-2, S. 164; P.A. 18-91, S. 1; P.A. 19-56, S. 10; June Sp. Sess. P.A. 21-2, S. 15; P.A. 22-118, S. 217, 251; P.A. 23-204, S. 205; P.A. 24-81, S. 217; P.A. 25-168, S. 135.)
History: June Sp. Sess. P.A. 17-2 effective January 1, 2018; P.A. 18-91 amended Subsec. (b) by deleting reference to July 1, 2018, adding new Subdiv. (2) re promoting effective health planning and provision of quality health care, redesignating existing Subdiv. (2) as Subdiv. (3) and amending same by deleting Subpara. (A) re all-payer claims database program and deleting Subpara. (B) designator, redesignating Subdiv. (3) as Subdiv. (4) and amending same by designating existing provision re coordinating state's health information technology initiatives as Subpara. (A), adding Subparas. (B) to (D) re administration of all-payer claims database program, consumer health information Internet web site, and duties of health information technology officer, respectively, redesignating Subdiv. (4) as Subdiv. (5) and amending same by replacing reference to Office of Health Care Access with reference to Health Systems Planning Unit, and redesignating Subdiv. (5) as Subdiv. (6), and amended Subsec. (c)(2) by deleting reference to Secs. 19a-755, 17b-59 and 17b-59a and adding reference to Sec. 17b-59g, effective May 14, 2018; P.A. 19-56 made a technical change in Subsec. (b)(4), effective June 28, 2019; June Sp. Sess. P.A. 21-2 amended Subsec. (b) by adding Subdiv. (7) re duties re covered Connecticut program under Secs. 19a-754c and 17b-312, effective June 23, 2021; P.A. 22-118 amended Subsec. (b)(7) by eliminating office oversight of Covered Connecticut program, deleting consultation with Commissioner of Social Services and Insurance Commissioner for purposes set forth in Sec. 17b-312, adding consultation with both commissioners and Connecticut Health Insurance Exchange on the Covered Connecticut program and deleting subparagraph designators (A) and (B) and further amended Subsec. (b) by adding Subdiv. (8) re Office of Health Strategy required to set annual cost growth benchmarks, primary care spending target, quality benchmarks, develop strategies to meet benchmarks, enhance transparency of provider entities, monitor development of accountable care organizations and patient-centered medical homes, monitor adoption of alternative payment methodologies and made technical changes, effective May 7, 2022; P.A. 23-204 amended Subsec. (b) by adding Subdiv. (9) re assistance in enrolling paraeducators in qualified health plans, the Covered Connecticut program or Medicaid, effective July 1, 2023; P.A. 24-81 amended Subsec. (a) by replacing “executive director of the Office of Health Strategy” with “Commissioner of Health Strategy”, effective May 30, 2024; P.A. 25-168 amended Subsec. (b)(9) by deleting former Subpara. (A) re qualified health plans for paraeducator and redesignating existing Subparas. (B) and (C) as Subparas. (A) and (B), effective July 1, 2025.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-754e. Health care expansion study. Report. (a) The Commissioner of Health Strategy, in consultation with the Office of Policy and Management, the Department of Social Services, the Connecticut Insurance Department and the Connecticut Health Insurance Exchange established pursuant to section 38a-1081, shall study the feasibility of offering health care coverage for (1) income-eligible children ages nine to eighteen, inclusive, regardless of immigration status, who are not otherwise eligible 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, and (2) adults with household income not exceeding two hundred per cent of the federal poverty level who do not otherwise qualify for medical assistance, an offer of affordable employer-sponsored insurance as defined in the Affordable Care Act, as an employee or a dependent of an employee, or health care coverage through the Connecticut Health Insurance Exchange due to household income.
(b) The study on the feasibility of providing health care coverage to income-eligible children ages nine to eighteen, inclusive, shall include, but not be limited to: (1) The age groups that would be provided medical assistance in each year, and appropriations necessary to provide such assistance, (2) income eligibility criteria and health care coverage consistent with the medical assistance programs established pursuant to sections 17b-261 and 17b-292, and (3) recommendations for identifying and enrolling such children in such coverage.
(c) The study on the feasibility of providing health care coverage for adults with household income not exceeding two hundred per cent of the federal poverty level shall include, but not be limited to: (1) Household income caps for adults who would be provided health care coverage in each year, and appropriations necessary to provide such coverage, (2) health care coverage consistent with the medical assistance programs established pursuant to section 17b-261 and the HUSKY D program as defined in section 17b-290, and (3) recommendations for identifying and enrolling such adults in such coverage.
(d) Not later than July 1, 2022, the commissioner shall report, in accordance with the provisions of section 11-4a, on provisions of the feasibility study 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 insurance and real estate.
(P.A. 21-176, S. 5; P.A. 24-81, S. 219; P.A. 25-97, S. 34.)
History: P.A. 21-176 effective July 12, 2021; P.A. 24-81 amended Subsecs. (a) and (d) by replacing references to executive director of the Office of Health Strategy with references to Commissioner of Health Strategy, effective May 30, 2024; P.A. 25-97 amended Subsec. (a) by making technical changes.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-754g. Development, publication and modification of health care cost growth benchmarks, primary care spending targets and health care quality benchmarks. (a) Not later than July 1, 2022, the commissioner shall publish (1) the health care cost growth benchmarks and annual primary care spending targets as a percentage of total medical expenses for the calendar years 2021 to 2025, inclusive, and (2) the annual health care quality benchmarks for the calendar years 2022 to 2025, inclusive, on the office's Internet web site.
(b) (1) (A) Not later than July 1, 2025, and every five years thereafter, the commissioner shall develop and adopt annual health care cost growth benchmarks and annual primary care spending targets for the succeeding five calendar years for provider entities and payers.
(B) In developing the health care cost growth benchmarks and primary care spending targets pursuant to this subdivision, the commissioner shall consider (i) any historical and forecasted changes in median income for individuals in the state and the growth rate of potential gross state product, (ii) the rate of inflation, and (iii) the most recent report prepared by the commissioner pursuant to subsection (b) of section 19a-754h.
(C) (i) The commissioner shall hold at least one informational public hearing prior to adopting the health care cost growth benchmarks and primary care spending targets for each succeeding five-year period described in this subdivision. The commissioner may hold informational public hearings concerning any annual health care cost growth benchmark and primary care spending target set pursuant to subsection (a) of this section or subdivision (1) of subsection (b) of this section. Such informational public hearings shall be held at a time and place designated by the commissioner in a notice prominently posted by the commissioner on the office's Internet web site and in a form and manner prescribed by the commissioner. The commissioner shall make available on the office's Internet web site a summary of any such informational public hearing and include the commissioner's recommendations, if any, to modify or not to modify any such annual benchmark or target.
(ii) If the commissioner determines, after any informational public hearing held pursuant to this subparagraph, that a modification to any health care cost growth benchmark or annual primary care spending target is, in the commissioner's discretion, reasonably warranted, the commissioner may modify such benchmark or target.
(iii) The commissioner shall annually (I) review the current and projected rate of inflation, and (II) include on the office's Internet web site the commissioner's findings of such review, including the reasons for making or not making a modification to any applicable health care cost growth benchmark. If the commissioner determines that the rate of inflation requires modification of any health care cost growth benchmark adopted under this section, the commissioner may modify such benchmark. In such event, the commissioner shall not be required to hold an informational public hearing concerning such modified health care cost growth benchmark.
(D) The commissioner shall post each adopted health care cost growth benchmark and annual primary care spending target on the office's Internet web site.
(E) Notwithstanding the provisions of subparagraphs (A) to (D), inclusive, of this subdivision, if the average annual health care cost growth benchmark for a succeeding five-year period described in this subdivision differs from the average annual health care cost growth benchmark for the five-year period preceding such succeeding five-year period by more than one-half of one per cent, the commissioner shall submit the annual health care cost growth benchmarks developed for such succeeding five-year period to the joint standing committee of the General Assembly having cognizance of matters relating to insurance for the committee's review and approval. The committee shall be deemed to have approved such annual health care cost growth benchmarks for such succeeding five-year period, except upon a vote to reject such benchmarks by the majority of committee members at a meeting of such committee called for the purpose of reviewing such benchmarks and held not later than thirty days after the commissioner submitted such benchmarks to such committee. If the committee votes to reject such benchmarks, the commissioner may submit to the committee modified annual health care cost growth benchmarks for such succeeding five-year period for the committee's review and approval in accordance with the provisions of this subparagraph. The commissioner shall not be required to hold an informational public hearing concerning such modified benchmarks. Until the joint standing committee of the General Assembly having cognizance of matters relating to insurance approves annual health care cost growth benchmarks for the succeeding five-year period, such benchmarks shall be deemed to be equal to the average annual health care cost growth benchmark for the preceding five-year period.
(2) (A) Not later than July 1, 2025, and every five years thereafter, the commissioner shall develop and adopt annual health care quality benchmarks for the succeeding five calendar years for provider entities and payers.
(B) In developing annual health care quality benchmarks pursuant to this subdivision, the commissioner shall consider (i) quality measures endorsed by nationally recognized organizations, including, but not limited to, the National Quality Forum, the National Committee for Quality Assurance, the Centers for Medicare and Medicaid Services, the National Centers for Disease Control and Prevention, the Joint Commission and expert organizations that develop health equity measures, and (ii) measures that: (I) Concern health outcomes, overutilization, underutilization and patient safety, (II) meet standards of patient-centeredness and ensure consideration of differences in preferences and clinical characteristics within patient subpopulations, and (III) concern community health or population health.
(C) (i) The commissioner shall hold at least one informational public hearing prior to adopting the health care quality benchmarks for each succeeding five-year period described in this subdivision. The commissioner may hold informational public hearings concerning the quality measures the commissioner proposes to adopt as health care quality benchmarks. Such informational public hearings shall be held at a time and place designated by the commissioner in a notice prominently posted by the commissioner on the office's Internet web site and in a form and manner prescribed by the commissioner. The commissioner shall make available on the office's Internet web site a summary of any such informational public hearing and include the recommendations, if any, to modify or not modify any such health care quality benchmark.
(ii) If the commissioner determines, after any informational public hearing held pursuant to this subparagraph, that modifications to any health care quality benchmarks are, in the commissioner's discretion, reasonably warranted, the commissioner may modify such quality benchmarks. The commissioner shall not be required to hold an additional informational public hearing concerning such modified quality benchmarks.
(D) The commissioner shall post each adopted health care quality benchmark on the office's Internet web site.
(c) The commissioner may enter into such contractual agreements as may be necessary to carry out the purposes of this section, including, but not limited to, contractual agreements with actuarial, economic and other experts and consultants.
(P.A. 22-118, S. 219; P.A. 24-24, S. 28; 24-81, S. 221; P.A. 25-97, S. 35.)
History: P.A. 22-118 effective May 7, 2022; P.A. 24-24 substituted “National Centers for Disease Control and Prevention” for “Centers for Disease Control”; P.A. 24-81 replaced references to executive director of the Office of Health Strategy with references to Commissioner of Health Strategy, effective May 30, 2024; P.A. 25-97 amended Subsec. (b)(1)(C)(i) by making a technical change.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |