Health & Home Care
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This site provides important information to health care providers about the Connecticut Medical Assistance Program. This site contains a wealth of resources for providers including enrollment, billing manuals, bulletins, program regulations, plus information on Electronic Data Interchange and the Automated Eligibility Verification System.
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Under this program, eligible pregnant women can receive case management and assistance with obtaining Medicaid/HUSKY coverage for themselves and their children. Information: dial 2-1-1, toll-free or visit www.infoline.org/informationlibrary/Documents/HEALTHYSTART.asp
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Information for pharmacy and health care providers, along with others interested in pharmacy-specific program information of the CT Medical Assistance Program (CTMAP), is available on the CTMAP website. This includes an extensive variety of topics, including Preferred Drug List Information and the Pharmaceutical and Therapeutics Committee.
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Connecticut Organ Transplant Program help residents pay for medical and ancillary expenses associated with an organ transplant.
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Reimbursement and Certificate of Need
The primary functions of Reimbursement and Certificate of Need (CON) include establishment of payment rates for Connecticut's Mediciad medical and residential care services, cost report auditing, and performing certificate of need reviews for nursing facilities, residential care homes, and ICF/MR development projects. Cost based rates are issued on an annual basis by the unit for services including hospitals, nursing facilities, home health care, clinics, and community residences for the elderly and disabled; as well as state-operated psychiatric hospitals, ICF/MR and federal Medicaid waiver services.
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Medicaid Nursing Home Reimbursement
Under the Connecticut Medicaid program, payment rates for nursing homes are set on a cost-based prospective basis in accordance with Section 17b-340 of the Connecticut General Statutes and Section 17-311-52 of the Regulations of Connecticut State Agencies.
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Medicaid Nursing Home Reimbursement Modernization Acuity Based Methodology
The Connecticut Department of Social Services (DSS) will be transitioning nursing facility reimbursement from a cost-based methodology to a prospective acuity-based or case mix, payment system. Visit this webpage for more information.
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The Department of Social Services is proud to announce a unique partnership with Hewlett Packard Enterprise and Sandata Technologies, LLC. in the implementation of Electronic Visit Verification (EVV).
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Welcome to our online toolkit for partners in service to Connecticut residents eligible for the HUSKY Health program. We hope you find this content informative and useful in helping clients access and maintain eligibility.