Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 17b-192-1. Scope (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-10. Payment rates for providers (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-11. Documentation (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-12. Grievance and administrative hearing process (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-2. Definitions (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-3. Administration of the SAGA medical program (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-4. Responsibilities of the ASO (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-5. Provider network (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-6. Services covered and limitations (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-7. Service management (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-8. Billing and payment procedures (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-192-9. Payment for hospitals (Repealed) Repealed June 11, 2014.(Adopted effective October 12, 2005; Repealed June 11, 2014)Notes: For 2014 repeal, see Sec. 54 of Public Act 14-187. (June 11, 2014)

Regulations of Connecticut State AgenciesSec. 17b-198-1. Scope. Effective date.As authorized by section 17b-198 of the Connecticut General Statutes, sections 17b-198-1 to 17b-198-19, inclusive, of the Regulations of Connecticut State Agencies, in conjunction with sections 8080 an…

Regulations of Connecticut State AgenciesSec. 17b-198-10. Calculation of benefits.(a) Method. (1) For an eligible assistance unit consisting of a married person whose spouse is included in his or her needs group, the monthly benefit payment shall be determined by: (A) Selecting t…

Regulations of Connecticut State AgenciesSec. 17b-198-11. Special benefits.(a) Generally. In addition to providing the assistance described in section 17b-198-10 of the Regulations of Connecticut State Agencies, the department shall, as a component of SAGA, provide special benefi…

Regulations of Connecticut State AgenciesSec. 17b-198-12. Issuance of benefits.(a) Definitions. As used in this section, \"electronic benefits transfer account\" means an account in a financial institution into which the department may deposit benefit payments that may be accesse…

Regulations of Connecticut State AgenciesSec. 17b-198-13. Application processing standards.(a) Standard processing deadline. (1) Except as provided in subsections (b) and (c) of this section: (A) For any application for assistance that requires the department to make a determinat…

Regulations of Connecticut State AgenciesSec. 17b-198-14. Continuing eligibility.(a) The renewal process. The department shall periodically determine whether an assistance unit's eligibility for assistance pursuant to SAGA should be renewed and whether such assistance unit is rec…

Regulations of Connecticut State AgenciesSec. 17b-198-15. Adverse action notice.(a) Definitions. For purposes of this section, \"adequate notice\" means notice concerning a termination, reduction or suspension of assistance pursuant to SAGA, or concerning a change in the manner o…

Regulations of Connecticut State AgenciesSec. 17b-198-16. Benefit and debit card replacement.(a) Definitions. As used in this section, \"electronic benefits transfer account\" has the same meaning as provided in subsection (a) of section 17b-198-12 of the Regulations of Connectic…

Regulations of Connecticut State AgenciesSec. 17b-198-17. Benefit payment error and correction. Administrative disqualification hearings.(a) Definitions. As used in this section, the following terms shall have the following meanings: (1) \"Overpayment\" means an amount of benefit…

Regulations of Connecticut State AgenciesSec. 17b-198-18. Methods of recovery.(a) Recovering from interests assigned to the department. (1) Subject to the provisions of subdivision (2) of this subsection, the department shall, pursuant to the assignment of interest required under…

Regulations of Connecticut State AgenciesSec. 17b-198-19. Certain benefit levels maintained.Notwithstanding the provisions of sections 17b-198-9 and 17b-198-10 of the Regulations of Connecticut State Agencies, any married person receiving SAGA benefits at the time said sections b…

Regulations of Connecticut State AgenciesSec. 17b-198-2. Definitions.As used in sections 17b-198-1 to 17b-198-19, inclusive, of the Regulations of Connecticut State Agencies: (1) \"AABD\" means the state supplement to the aged, blind or disabled administered pursuant to section 1…

Regulations of Connecticut State AgenciesSec. 17b-198-3. Beginning the eligibility process.(a) Application required. (1) Except as provided in subsection (b) of this section, any person seeking assistance pursuant to SAGA shall complete and submit to the department an application…

Regulations of Connecticut State AgenciesSec. 17b-198-4. Rules for forming the assistance unit and needs group.(a) Assistance unit composition. Each person requesting or receiving assistance pursuant to SAGA shall be designated a one-member assistance unit, regardless of whether …

Regulations of Connecticut State AgenciesSec. 17b-198-5. Determining eligibility. Threshold considerations.(a) Citizenship status. Only (1) a United States citizen, (2) a qualified alien, as defined in 8 USC 1641, as amended from time to time, who is not eligible for federally fu…

Regulations of Connecticut State AgenciesSec. 17b-198-6. Determining eligibility. Assistance unit obligations.(a) Disclosure of Social Security number. (1) Each assistance unit member shall disclose his or her Social Security number as a condition of eligibility for assistance pu…

Regulations of Connecticut State AgenciesSec. 17b-198-7. Determining eligibility. Employability status.(a) Impairment to employability required. No person shall be eligible for assistance pursuant to SAGA unless such person is unemployable, as described in subsections (b) and (c)…

Regulations of Connecticut State AgenciesSec. 17b-198-8. Determining eligibility. Asset restrictions.(a) Definitions. As used in this section, the following terms shall have the following meanings, unless a provision expressly provides otherwise: (1) \"Available asset\" or \"asse…

Regulations of Connecticut State AgenciesSec. 17b-198-9. Determining eligibility. Income restrictions.(a) Definitions. As used in this section, the following terms shall have the following meanings: (1) \"Applied income\" means the portion of the counted income of a person or nee…

Regulations of Connecticut State AgenciesSec. 17b-262-1. ScopeSections 17b-262-2 to 17b-262-9 inclusive set forth the requirements for payment of Home Health services provided to individuals who are determined eligible to receive services under Connecticut's Medical Assistance Pr…

Regulations of Connecticut State AgenciesSec. 17b-262-1000. Prior authorization requirements(a) In order to receive payment from the department, each FQHC shall comply with all prior authorization requirements. The department in its sole discretion determines what information is …

Regulations of Connecticut State AgenciesSec. 17b-262-1001. Change in scope of services(a) Each FQHC shall notify the department of any increase or decrease in the scope of services provided by the FQHC in accordance with section 17b-245d of the Connecticut General Statutes. If t…

Regulations of Connecticut State AgenciesSec. 17b-262-1002. Billing requirements(a) Each FQHC shall bill for FQHC services per encounter. Claims are limited to one all-inclusive encounter per day to include all services received by a client on the same day unless the client suffe…

Regulations of Connecticut State AgenciesSec. 17b-262-1003. Reimbursement(a) The department shall reimburse a FQHC an all-inclusive encounter rate per client encounter in accordance with a PPS as required by 42 USC 1396a (bb). (b) The department shall establish the baseline encou…

Regulations of Connecticut State AgenciesSec. 17b-262-1004. Documentation and audit requirements(a) Each FQHC shall maintain a specific record for all services provided to each client including, but not limited to: name, address, birth date, Medicaid Identification Number, pertin…

Regulations of Connecticut State AgenciesSec. 17b-262-1006. ScopeSections 17b-262-1006 to 17b-262-1017, inclusive, of the Regulations of Connecticut State Agencies set forth the Department of Social Services requirements for the payment of dental services for clients who are dete…

Regulations of Connecticut State AgenciesSec. 17b-262-1007. DefinitionsAs used in section 17b-262-1006 to section 17b-262-1017, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Adjunctive dental services\" means services that are not primarily dental in nature b…

Regulations of Connecticut State AgenciesSec. 17b-262-1008. Provider Participation (a) In order to participate in the Connecticut Medicaid program and provide dental services eligible for reimbursement from the department, each dental provider shall: (1) Comply with all applicabl…

Regulations of Connecticut State AgenciesSec. 17b-262-1009. EligibilityPayments for dental services shall be made available to CMAP providers for members enrolled in the CMAP. (Effective July 9, 2025)

Regulations of Connecticut State AgenciesSec. 17b-262-1010. Administrative Services Organization (a) The department may contract with an administrative services organization, or ASO, to administer dental health services in accordance with a contract between the ASO and the depart…

Regulations of Connecticut State AgenciesSec. 17b-262-1011. Services covered and limitations Non-exhaustive coverage for dental services and limitations to such services are set forth in subsections (a) to (j), inclusive, of this section subject to the exception process through p…

Regulations of Connecticut State AgenciesSec. 17b-262-1012. Services not coveredThe following services are not covered by the CMAP: (a) Adjunctive dental services: General anesthesia and conscious sedation (1) For members over the age of twelve who do not have a cognitive impairm…

Regulations of Connecticut State AgenciesSec. 17b-262-1013. Documentation(a) The member's chart and dental records shall contain the following information: (1) The member's full name, including such member’s first, middle, and last name; (2) The member's residential and mailing a…

Regulations of Connecticut State AgenciesSec. 17b-262-1014. Need for Service and Authorization Process (a) The need for a dental service includes any services that are deemed by the department to be medically necessary and that: (1) Are within the scope of the dentist's practice;…

Regulations of Connecticut State AgenciesSec. 17b-262-1015. Payment(a) The Commissioner shall establish the fees contained in the dental fee schedule annually. The fees shall be based on moderate and reasonable rates prevailing in the respective communities where the services are…

Regulations of Connecticut State AgenciesSec. 17b-262-1016. Billing(a) All dental services performed on behalf of members that do not require prior authorization or post-procedure review shall be recorded in the member's permanent record and submitted to the department's claims p…

Regulations of Connecticut State AgenciesSec. 17b-262-1017. Marketing Guidelines (a) Prohibited marketing activities. Any dental provider, including a dentist, dental clinic, mobile dental clinic or SBHC, participating in the CMAP shall not engage in any marketing activity, inclu…

Regulations of Connecticut State AgenciesSec. 17b-262-10—17b-262-201. Reserved