Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 17-12a-18. Household cooperation(a) GeneralAs a condition of eligibility households are required to cooperate in the initial application process, in reviews generated by reported changes, in redeterminations and in Quality Control rev…

Regulations of Connecticut State AgenciesSec. 17-12a-22. Duplicate participation(a) General StatementThe Department of Income Maintenance has the responsibility to detect and terminate instances of duplicate participation. (b) DefinitionDuplicate ParticipationHouseholds or indivi…

Regulations of Connecticut State AgenciesSec. 17-12a-24. Restoration of lost food stamp benefits to public assistance and non-public assistance households(a) GeneralFood Stamp benefits are restored for not more than twelve months when a judicial action has found benefits to be wr…

Regulations of Connecticut State AgenciesSec. 17-12a-28. Standard deduction and excess shelter/dependent care deduction in the food stamp program(a) Standard DeductionA standard deduction of ninety-eight ($98) dollars per household per month is used in the computation of availabl…

Regulations of Connecticut State AgenciesSec. 17-134d-139. ScopeSections 17-134d-140 to 17-134d-149 inclusive set forth the requirements for payment of Case Management Services provided by the State of Connecticut Department of Mental Health to persons determined eligible to rece…

Regulations of Connecticut State AgenciesSec. 17-134d-140. DefinitionsFor the purposes of Regulation Sections 17-134d-139 through 17-134d-149, the following definitions shall apply: (a) \"Case Manager\" means the person employed by the Department of Mental Health or performing pr…

Regulations of Connecticut State AgenciesSec. 17-134d-141. Provider participationIn order to participate in the Connecticut Medical Assistance Program and receive payment from the Department for the case management services rendered, the Department of Mental Health shall: (1) pro…

Regulations of Connecticut State AgenciesSec. 17-134d-142. EligibilityPayment for case management services is available only on behalf of all persons specified as members of the target group, pursuant to subsection (a) of 17-134d-144, who are eligible to receive services pursuant…

Regulations of Connecticut State AgenciesSec. 17-134d-143. Services coveredCase management services may include the continuum of activities systematically carried out by an individual case manager that are available to assist and enable an eligible person to gain access to needed…

Regulations of Connecticut State AgenciesSec. 17-134d-144. Limitations(a) Target Group Limitations(1) Payment for case management services is limited to case management services provided to eligible persons with chronic mental illness as defined in the Department of Mental Health…

Regulations of Connecticut State AgenciesSec. 17-134d-145. Need for servicesPayment for case management services will be made by the Department only if the eligible person evidences a need for case management services, and if they meet the requirements to receive services from th…

Regulations of Connecticut State AgenciesSec. 17-134d-146. Documentation requirementsCase management services will be reimbursed by the Department only when documentation of compliance with the following requirements is on file with the Department of Mental Health or its performi…

Regulations of Connecticut State AgenciesSec. 17-134d-147. Billing requirementsAll bills submitted to the Department for payment of case management services must be substantiated by documentation in the eligible person's permanent service record pursuant to Section 17-134d-146. (…

Regulations of Connecticut State AgenciesSec. 17-134d-148. PaymentPayment by the Department for case management services rendered to eligible persons shall be based on the providers' actual direct and indirect costs to provide case management services. Said costs shall be filed a…

Regulations of Connecticut State AgenciesSec. 17-134d-149. AuditAll supporting accounting and business records, statistical data, and all other records relating to the provision of case management services paid for by the Department shall be subject to audit. If an audit disclose…

Regulations of Connecticut State AgenciesSec. 17-134d-33. Medical transportation services(a) ScopeThese regulations set forth the requirements for payment of Medical Transportation Services rendered to persons determined eligible for such services under provisions of Connecticut'…

Regulations of Connecticut State AgenciesSec. 17-134d-36. Administratively necessary days(a) Administratively Necessary Days are inpatient hospital days reimbursed by Medicaid for services to a Title XIX eligible patient and to a patient who will eventually be determined eligible…

Regulations of Connecticut State AgenciesSec. 17-134d-39. Reimbursement plan for medical transportation under the medical assistance program(a) Medical Transportation Services provided under the Medical Assistance Program will be purchased through a Volume Purchase Plan (V.P.P.),…

Regulations of Connecticut State AgenciesSec. 17-134d-43. Medicaid requirements for organ transplantation(a) Organ transplantations are covered under the Medicaid program if they are of demonstrated therapeutic value, medically necessary and medically appropriate, and likely to r…

Regulations of Connecticut State AgenciesSec. 17-134d-46. Customized wheelchairs in nursing facilities as defined in 42 USC 1396r(a), as amended from time to time, and ICFs/MR as defined in 42 USC 1396(d)d, as amended from time to time(a) Conditions of ParticipationNursing facili…

Regulations of Connecticut State AgenciesSec. 17-134d-50. Medicaid reimbursement clinical diagnostic laboratory services furnished by acute care hospitals(a) Definitions(1) This regulation defines the method of reimbursement of clinical diagnostic laboratory services provided by …

Regulations of Connecticut State AgenciesSec. 17-134d-56. Reimbursement of clinic outpatient services and clinic off-site medical services furnished by free-standing clinics(a) Definitions(1) \"Free-Standing Clinic\" means a facility providing medical or medically related clinic …

Regulations of Connecticut State AgenciesSec. 17-134d-63. Medicaid payment to out-of-state and border hospitals(a) DefinitionsFor the purposes of this regulation, the following definitions apply:(1) \"Allowed Cost\" means the Medicaid costs reported by each Connecticut instate ho…

Regulations of Connecticut State AgenciesSec. 17-134d-68. Requirements for monitoring psychiatric admissions to nursing homes(a) Scope(1) Medicaid is a program of \"cooperative federalism\" wherein federal financial participation is available for a percentage of the cost of medic…

Regulations of Connecticut State AgenciesSec. 17-134d-79. Requirements for the reservation of beds in nursing homes(a) Definitions(1) The definitions contained in Section 19a-537 of the Connecticut General Statutes apply to this subsection and subsections (b), (c) and (d) of this…

Regulations of Connecticut State AgenciesSec. 17-134d-80. Title XIX utilization review requirements for medicaid services in general hospitals(a) DefinitionsFor purposes of this regulation, the following definitions apply:(1) Acute Care means the medical care needed for an illnes…

Regulations of Connecticut State AgenciesSec. 17-134d-81. Policy and procedures governing the billing and payment for prescription drugs on behalf of title XIX medicaid recipients(a) ScopeThis regulation governs the billing and payment for prescription drugs and Pharmaceutical Se…

Regulations of Connecticut State AgenciesSec. 17-134d-82. Requirements for payment of case management services(a) ScopeThese regulations set forth the requirements for payment of Case Management Services provided by the State of Connecticut Department of Mental Retardation to per…

Regulations of Connecticut State AgenciesSec. 17-134d-83. Policy and procedures governing oxygen therapy on behalf of Title XIX medicaid recipients(a) ScopeSection 17-134d-83 through Section 17-134d-85 of the regulations of Connecticut State Agencies governs the billing and payme…

Regulations of Connecticut State AgenciesSec. 17-134d-84. Policy and procedures governing the need for service for oxygen therapy on behalf of Title XIX medicaid recipients(a) Need for ServicesThe Department will pay for oxygen therapy for any recipient who meets the criteria est…

Regulations of Connecticut State AgenciesSec. 17-134d-85. Policy and procedures governing the billing and payment for oxygen therapy on behalf of title XIX medicaid recipients(a) Billing Procedure(1) Form H.C.F.A. 1500 \"Health Insurance Claim Form\" is used to bill for oxygen th…

Regulations of Connecticut State AgenciesSec. 17-134d-86. Medicaid payment for general hospital outpatient emergency and non-emergency visits to a hospital emergency room and outpatient clinic visits(a) Definitions(1) \"Department\" means The State of Connecticut Department of In…

Regulations of Connecticut State AgenciesSec. Appendix A. The following are the diagnoses codes which would be acceptable justification for invalid coach transportation. Invalid coach trips with these diagnoses do not require prior authorization. 170.2Malignant neoplasm of bone, …

Regulations of Connecticut State AgenciesSec. Appendix B. The following are conditions which would be acceptable justification for non-emergency ambulance. Non-emergency ambulance trips for clients with these conditions or needing these services do not require prior authorization…

Regulations of Connecticut State AgenciesSec. 17-136i-1—17-136i-19. Transferred, February 26, 1992Correlated TableOld SectionNew Section17-136i-117a-306-117-136i-217a-306-217-136i-317a-306-317-136i-417a-306-417-136i-517a-306-517-136i-617a-306-617-136i-717a-306-717-136i-817a-306-8…

Regulations of Connecticut State AgenciesSec. 17-174-1. Purpose of licensingThe purpose of licensing community residences owned by private parties or agencies is to insure the maintenance of adequate standards of care for the retardates who need protective and developmental livin…

Regulations of Connecticut State AgenciesSec. 17-174-2. DefinitionsFor the purpose of sections 17-174-1 to 17-174-7, inclusive, a private dwelling used as a community residence for the mentally retarded means a residence privately owned and managed in which the director or superi…

Regulations of Connecticut State AgenciesSec. 17-174-3. Standards for community residences(a) General conditions.(1) The facility including general equipment and the sanitation and maintenance of the home shall insure the health, comfort and safety of the residents at all times. …

Regulations of Connecticut State AgenciesSec. 17-174-4. License application: Investigation: Issuance, transfer(a) Application. The office of mental retardation shall prescribe and furnish application forms to be submitted to it by all applicants for a license. (b) References and …

Regulations of Connecticut State AgenciesSec. 17-174-5. License not requiredLicense for a community residence shall not be required for the care of a single child placed under authority of an office of mental retardation facility only if no other child or adult under similar auth…

Regulations of Connecticut State AgenciesSec. 17-174-6. Expiration and license renewal: Reinvestigation(a) All licenses issued by the office of mental retardation shall be for a term not to exceed one year from the date of issuance, unless revoked prior to the expiration of the t…

Regulations of Connecticut State AgenciesSec. 17-174-7. Revocation: Refusal to renew licenseThe office of mental retardation may revoke or refuse to renew the license of any community residence, if the licensee fails to comply with these regulations at any time. Notice thereof in…

Regulations of Connecticut State AgenciesSec. 17-183-1. Reporting of statistics by private facilitiesThe person in charge of every private hospital for mental illness in the state shall, on a quarterly basis, supply the commissioner of mental health in writing with statistics whi…

Regulations of Connecticut State AgenciesSec. 17-183-2. Procedure for reporting statistics(a) Said statistics shall be reported on forms provided by the department of mental health on or before February 1, May 1, August 1, and September 1 of each year. Each such report shall cove…

Regulations of Connecticut State AgenciesSec. 17-2-140. DefinitionsA. Patient's Personal Allowance. The Patient's Personal Allowance (PPA) is the amount of money that patients who are recipients of Medical Assistance in Long-Term Care Facilities have accumulated from the amount a…

Regulations of Connecticut State AgenciesSec. 17-2-141. Purpose of patient's personal allowance policyThe purpose of the Patient's Personal Allowance (PPA) Policy is to establish standards and accounting controls for PPA when the Long-Term Care Facility acts as trustee for public…

Regulations of Connecticut State AgenciesSec. 17-2-142. Patient's authorization for facility to manage fundsWhen a facility assumes responsibility for funds for a patient receiving Medical Assistance, there must be a statement on file signed by the patient, his guardian, conserva…