Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 17a-451(c)-1. DefinitionsAs used in Sections 17a-451 (c)-1 to 17a-451 (c)-5, inclusive:(a) \"Category of personal data\" means the classifications of personal information set forth in the Personal Data Act, Conn. Gen. Stat. Sec. 4-190…

Regulations of Connecticut State AgenciesSec. 17a-451(c)-2. General nature and purpose of personal data systemsThe Department of Mental Health maintains the following personal data systems:(a) Personnel Records(1) Personnel records are maintained at the Department facility which …

Regulations of Connecticut State AgenciesSec. 17a-451(c)-3. Maintenance of personal data(a) Records for each personal data system are maintained in accordance with schedules prepared by the Connecticut State Library, Department of Public Records Administration and retention sched…

Regulations of Connecticut State AgenciesSec. 17a-451(c)-4. Disclosure of personal data(a) Within four (4) business days of receipt of a written request for disclosure of personal data, the Department shall mail or deliver to the requesting individual a written response, in plain…

Regulations of Connecticut State AgenciesSec. 17a-451(c)-5. Procedure for contesting the content of personal data(a) Any person who believes that the Department is maintaining inaccurate, incomplete or irrelevant personal data concerning her/him may file a written request with th…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-1. DefinitionsAs used in sections 17a-451 (t)-1 to 17a-451 (t)-19, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Client\" means a person with a psychiatric disability, a substance use disorder, or both,…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-10. Eligibility for a hearingAny client who has received an unfavorable final determination from DMHAS and (a) requested and was denied a mental health or substance use disorder service from a covered service provider, or (…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-11. Request for a hearingA request for a hearing shall be mailed to the Commissioner not later than thirty calendar days after the date of mailing of the final determination. A request for a hearing shall identify the menta…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-12. Scheduling and notice of hearingUpon receipt of a request for a hearing, the Commissioner shall designate a hearing officer. The hearing officer shall schedule a hearing to be held not later than forty-five calendar day…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-13. Resolution of request for hearing(a) A request for a hearing shall be resolved pursuant to section 4-177 of the Connecticut General Statutes in one or more of the following ways: (1) The client's withdrawal of the reque…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-14. Conduct of proceedingsThe hearing shall be conducted as a contested case under the provisions of Chapter 54 of the Uniform Administrative Procedure Act, sections 4-166 to 4-189, inclusive, of the Connecticut General Sta…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-15. Witnesses and testimonyAll witnesses shall be under oath. The client may act as a witness on the client's own behalf, and may bring additional witnesses. DMHAS and any affected covered service provider may present any a…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-16. ExhibitsIf a witness wishes to retain possession of a document, a copy of the original may be admitted, or the hearing officer may dictate the relevant portions into the record. (Effective June 29, 2012)

Regulations of Connecticut State AgenciesSec. 17a-451(t)-17. SubpoenasThe hearing officer shall have the power to compel, by subpoena, the attendance and testimony of witnesses and the production of books and papers. (Effective June 29, 2012)

Regulations of Connecticut State AgenciesSec. 17a-451(t)-18. Record of proceedingsA mechanical recording of the proceedings shall be made for use by the hearing officer in preparing the proposed decision and shall be made available to any party upon request. (Effective June 29, 2…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-19. Final decisionUpon conclusion of the hearing, the hearing officer shall prepare a proposed written decision and shall mail it to the parties by certified mail, return receipt requested, as well as providing it to the Co…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-2. ApplicabilityOnly those covered service providers supported partially or in full with DMHAS funds are subject to sections 17a-451 (t)-1 to 17a-451 (t)-19 inclusive of the Regulations of Connecticut State Agencies. The Co…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-3. PostingAll covered service providers shall prominently post a summary version of this regulation, in a form provided by the Commissioner, together with the name and telephone number of the relevant client rights officer,…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-4. NoticeIf a covered service provider denies, involuntarily reduces or terminates a mental health or substance use disorder service, then the covered service provider shall provide the client with a written notice of the a…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-5. Filing of grievances(a) A written grievance may be filed by a client or by a person authorized by law to act on behalf of the client with the client rights officer. Except as provided under section 17a-451 (t)-7 of the R…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-6. Grievance review procedure(a) Not later than seven days after the filing of a grievance, the client rights officer shall acknowledge receipt of the grievance. The client rights officer shall interview the client and othe…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-7. Accelerated grievances(a) An accelerated grievance may be filed by a client or a person authorized by law to act on the client's behalf regarding, (1) the involuntary reduction or termination of opioid substitution thera…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-8. Requests for continuation of mental health or substance use disorder services(a) If a covered service provider or the covered service provider's designee terminated mental health or substance use disorder services withou…

Regulations of Connecticut State AgenciesSec. 17a-451(t)-9. Further review(a) A client may request the Commissioner or the Commissioner's designee to conduct a further review of a decision of a covered service provider not later than fifteen business days after the client's recei…

Regulations of Connecticut State AgenciesSec. 17a-453a-1. ScopeThese regulations are issued pursuant to subsection (b) of section 17a-453a of the Connecticut General Statutes and govern the operation of the behavioral health managed care program for eligible recipients of medical…

Regulations of Connecticut State AgenciesSec. 17a-453a-10. Quality management(a) Compliance with confidentiality requirements: The contracted provider shall comply with all state and federal requirements pertaining to the communication, storage, dissemination, and retention of co…

Regulations of Connecticut State AgenciesSec. 17a-453a-11. Provider application(a) In order to be considered for participation in the GABHP, a provider shall request in writing an application packet from the designated agent. The application packet shall be completed by the provi…

Regulations of Connecticut State AgenciesSec. 17a-453a-12. Provider credentials(a) The provider credentialing process is described as follows: (1) The purpose of the credentialing process is for DMHAS to determine if a provider applying to participate in the GABHP has the requisi…

Regulations of Connecticut State AgenciesSec. 17a-453a-13. Provider contract(a) DMHAS, in its sole discretion, may extend an offer to contract with a provider who has been credentialed for covered behavioral health services under the GABHP. (1) A provider who has been credentiale…

Regulations of Connecticut State AgenciesSec. 17a-453a-14. Administration of contracted providers' claims for payment(a) Contracted providers shall only be paid for covered behavioral health services that: (1) Are delivered to eligible recipients; and(2) The contracted provider r…

Regulations of Connecticut State AgenciesSec. 17a-453a-15. Provider claim for payment grievance process(a) If a contracted provider's claim for payment is denied by the designated agent, the contracted provider may file a claim for payment grievance with the designated agent. Con…

Regulations of Connecticut State AgenciesSec. 17a-453a-16. Audit(a) DMHAS or its designated agent may conduct audits of a contracted provider's clinical, programmatic, fiscal or other records to verify the accuracy of the contracted provider's claims for payment and the contracte…

Regulations of Connecticut State AgenciesSec. 17a-453a-17. Administrative hearing to appeal audit recovery or progressive sanctions(a) Contracted providers have a right to an administrative hearing as follows: (1) The contracted provider is subject to recovery of payments followi…

Regulations of Connecticut State AgenciesSec. 17a-453a-18. Appeals and fair hearingsThere are two (2) types of appeals that an individual may file with DMHAS or its designated agent: (a) First-level appeal.(1) A first-level appeal may be filed by the individual or his or her auth…

Regulations of Connecticut State AgenciesSec. 17a-453a-19. Out-of-network providers(a) An out-of-network provider is a provider who does not have an executed contract with DMHAS to participate in GABHP. An out-of-network provider only may deliver covered behavioral health service…

Regulations of Connecticut State AgenciesSec. 17a-453a-2. DefinitionsAs used in sections 17a-453a-1 to 17a-453a-19, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Acute care services\" means short-term inpatient treatment for a psychiatric disability, substanc…

Regulations of Connecticut State AgenciesSec. 17a-453a-3. Eligibility(a) In order to be eligible for covered behavioral health services under the GABHP, the individual shall: (1) Be determined eligible by DSS for medical services pursuant to section 17b-192 of the Connecticut Gen…

Regulations of Connecticut State AgenciesSec. 17a-453a-4. Covered behavioral health servicesThe following behavioral health services shall be covered behavioral health services within the GABHP: (1) Acute psychiatric hospitalization: A medically necessary, inpatient behavioral he…

Regulations of Connecticut State AgenciesSec. 17a-453a-5. Limitations, exclusions and non-payment of behavioral health services(a) Limitations: The following limitations shall apply: (1) DMHAS payment for outpatient therapy shall be limited to one (1) session per contracted provi…

Regulations of Connecticut State AgenciesSec. 17a-453a-6. Prior authorization review(a) The prior authorization review shall determine whether covered behavioral health services are medically necessary and determine the appropriate level of care. Contracted providers shall obtain…

Regulations of Connecticut State AgenciesSec. 17a-453a-7. Continued stay authorization review(a) The continued stay authorization review shall determine whether previously authorized covered behavioral health services continue to be medically necessary. If a contracted provider d…

Regulations of Connecticut State AgenciesSec. 17a-453a-8. Alternative authorization review(a) Web-based registration or outpatient treatment review (OTR) submission shall be the alternative methods to prior authorization review and continued stay review. The web-based registratio…

Regulations of Connecticut State AgenciesSec. 17a-453a-9. Recovery and discharge planningExcept for those providing laboratory services, all contracted providers shall meet the following requirements: (a) The contracted provider shall develop a recovery plan with each eligible re…

Regulations of Connecticut State AgenciesSec. 17a-50-1. Definitions (Repealed) Repealed May 11, 2018.(Effective February 8, 1993; Repealed May 11, 2018) AUTHORITY: Conn. Gen. Stat. § 17a-50 AUTHORITY: Conn. Gen. Stat. § 17a-50

Regulations of Connecticut State AgenciesSec. 17a-50-2. Children's trust fund purpose (Repealed) Repealed May 11, 2018.(Effective February 8, 1993; Repealed May 11, 2018) AUTHORITY: Conn. Gen. Stat. § 17a-50 AUTHORITY: Conn. Gen. Stat. § 17a-50

Regulations of Connecticut State AgenciesSec. 17a-50-3. Program management (Repealed) Repealed May 11, 2018.(Effective February 8, 1993; Repealed May 11, 2018) AUTHORITY: Conn. Gen. Stat. § 17a-50 AUTHORITY: Conn. Gen. Stat. § 17a-50

Regulations of Connecticut State AgenciesSec. 17a-50-4. Fiscal management (Repealed) Repealed May 11, 2018.(Effective February 8, 1993; Repealed May 11, 2018) AUTHORITY: Conn. Gen. Stat. § 17a-50 AUTHORITY: Conn. Gen. Stat. § 17a-50