Department of Social Services › 17b-262 Requirements for Payment of Home Health Agencies

Regulations of Connecticut State AgenciesSec. 17b-262-960. EligibilityPayment to a provider for birth center services is available for clients who have a need for such products and services when the items are medically necessary, subject to the conditions and limitations set fort…

Regulations of Connecticut State AgenciesSec. 17b-262-961. Services covered and limitations(a) The department shall pay the provider a single all-inclusive fee for a normal, uncomplicated labor and delivery, which covers all services provided by the birth center, including, but n…

Regulations of Connecticut State AgenciesSec. 17b-262-962. Payment and payment limitations(a) The department shall reimburse the provider when the provider has met all the requirements of sections 17b-262-956 to 17b-262-965, inclusive, of the Regulations of Connecticut State Agen…

Regulations of Connecticut State AgenciesSec. 17b-262-963. Prior authorization(a) The department shall require prior authorization for: (1) Any service identified on the department's fee schedule as requiring prior authorization;(2) EPSDT special services; and(3) any service that…

Regulations of Connecticut State AgenciesSec. 17b-262-964. Billing procedureProviders shall submit claims on a hard copy invoice or by electronic transmission to the department in a form and manner specified by the department, together with all information required by the departm…

Regulations of Connecticut State AgenciesSec. 17b-262-965. Documentation(a) Providers shall maintain a specific record for all services provided to each client, including, but not limited to: name, address, birth date, Medicaid identification number, pertinent diagnostic informat…

Regulations of Connecticut State AgenciesSec. 17b-262-966. Reserved

Regulations of Connecticut State AgenciesSec. 17b-262-994. ScopeSections 17b-262-994 to 17b-262-1004, inclusive, of the Regulations of Connecticut State Agencies set forth the Department of Social Services’ requirements for payment to federally qualified health centers for servic…

Regulations of Connecticut State AgenciesSec. 17b-262-995. DefinitionsAs used in section 17b-262-994 to section 17b-262-1004, inclusive, of the Regulations of Connecticut State Agencies: (1) “Advanced practice registered nurse” or “APRN” means a person licensed under section 20-9…

Regulations of Connecticut State AgenciesSec. 17b-262-996. Provider participationIn order to participate in the Connecticut Medicaid program and provide FQHC services eligible for reimbursement from the department, each FQHC shall: (1) Comply with all applicable state licensing r…

Regulations of Connecticut State AgenciesSec. 17b-262-997. Services covered(a) Covered core services for FQHCs include the following: (1) Medical services furnished by a physician, PA, APRN or nurse midwife. The services shall be within the scope of practice of his or her profess…

Regulations of Connecticut State AgenciesSec. 17b-262-998. Services not coveredThe following services are not covered:(1) Services that are not covered in the Medicaid state plan;(2) Services that are not medically necessary;(3) Canceled services or appointments that are not kept…

Regulations of Connecticut State AgenciesSec. 17b-262-999. Billable services(a) Billable services for FQHCs shall include core and noncore services identified in section 17b-262-997 of the Regulations of Connecticut State Agencies. (b) Covered core and noncore services shall be b…