Connecticut Administrative Code

Regulations of Connecticut State AgenciesSec. 17b-262-921. Billing procedures(a) Providers shall submit claims on the department's designated form or by electronic transmission as established by the department and shall include all information required by the department to proces…

Regulations of Connecticut State AgenciesSec. 17b-262-922. Payment(a) Licensed behavioral health clinicians who are fully or partially compensated by a Medicaid participating general hospital, public or private institution, freestanding clinic or federally qualified health center…

Regulations of Connecticut State AgenciesSec. 17b-262-923. Payment rateThe commissioner shall establish, update and publish the department's fee schedule pursuant to section 4-67c of the Connecticut General Statutes. (Effective December 28, 2012)

Regulations of Connecticut State AgenciesSec. 17b-262-924. Payment limitations(a) The fees for a diagnostic interview examination, as stipulated in the department's applicable fee schedule, represent one unit of service. The provider shall bill for only one unit of service for a …

Regulations of Connecticut State AgenciesSec. 17b-262-925. Documentation(a) Providers shall maintain (1) a specific record for all services provided to each client including, but not limited to: name, address, birth date, Medicaid identification number, pertinent diagnostic infor…

Regulations of Connecticut State AgenciesSec. 17b-262-956. ScopeSections 17b-262-956 to 17b-262-965, inclusive, of the Regulations of Connecticut State Agencies set forth the Department of Social Services requirements for payment to birth centers that are medically necessary and …

Regulations of Connecticut State AgenciesSec. 17b-262-957. DefinitionsAs used in sections 17b-262-956 to 17b-262-965, inclusive, of the Regulations of Connecticut State Agencies: (1) \"Birth center\" means a free-standing, separately licensed health care facility that is not a ho…

Regulations of Connecticut State AgenciesSec. 17b-262-958. Provider participation(a) To enroll in Medicaid and receive payment from the department, a provider shall comply with sections 17b-262-956 to 17b-262-965, inclusive, of the Regulations of Connecticut State Agencies and se…

Regulations of Connecticut State AgenciesSec. 17b-262-959. Need for serviceService in a birth center shall be limited to maternal patients who have had a low-risk pregnancy and are likely to have a low-risk delivery, as determined by the maternal patient's licensed practitioner. …

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…

Regulations of Connecticut State AgenciesSec. 17b-27-1. DefinitionsAs used in sections 17b-27-1 through 17b-27-7, inclusive:(1) \"Acknowledgment of paternity\" means the form prescribed by the Department of Public Health for the purpose of establishing the legal paternity of a ch…

Regulations of Connecticut State AgenciesSec. 17b-27-2. Protocol requirement(a) In generalEach birthing institution shall develop and follow a protocol for the voluntary acknowledgment of paternity during the period immediately before or after the birth of a child to an unmarried…

Regulations of Connecticut State AgenciesSec. 17b-27-3. Informational materialsThe birthing institution shall distribute to both the mother and the putative father, if he is present in such institution, written informational materials about paternity establishment. Such materials…

Regulations of Connecticut State AgenciesSec. 17b-27-4. Forms and noticesThe birthing institution shall provide to both the mother and the putative father, if he is present in such institution, the forms and notices necessary to voluntarily affirm and acknowledge paternity, respe…

Regulations of Connecticut State AgenciesSec. 17b-27-5. ConsultationThe birthing institution shall provide to both the mother and the putative father, if he is present in such institution, the opportunity to speak with staff, either by telephone or in person, who are trained to c…

Regulations of Connecticut State AgenciesSec. 17b-27-6. Affirmation and acknowledgment opportunity(a) In generalThe requirements of this section shall be satisfied if the birthing institution provides the required services, including notarization, prior to the mother's discharge,…

Regulations of Connecticut State AgenciesSec. 17b-27-7. FilingThe birthing institution shall promptly forward the acknowledgment of paternity completed in accordance with section 17b-27-6 of the Regulations of Connecticut State Agencies to the paternity registry established and m…

Regulations of Connecticut State AgenciesSec. 17b-27-8. (Repealed) Repealed June 8, 1998.

Regulations of Connecticut State AgenciesSec. 17b-3-1—17b-3-6. (Repealed) Repealed July 10, 2001.

Regulations of Connecticut State AgenciesSec. 17b-34-1. ScopeThe department distributes Electronic Health Record Incentive Program payments to eligible providers who meet the criteria set forth in 42 CFR 495.2 to 42 CFR 495.10, inclusive, and 42 CFR 495.300 to 42 CFR 495.370, inc…

Regulations of Connecticut State AgenciesSec. 17b-34-2. DefinitionsUnless otherwise defined in this section, the definitions provided in 42 CFR 495.4 and 42 CFR 495.302 apply to sections 17b-34-1 to 17b-34-9, inclusive, of the Regulations of Connecticut State Agencies. As used in…

Regulations of Connecticut State AgenciesSec. 17b-34-3. General Requirements for ParticipationTo be eligible for participation in the EHR Incentive Program, a provider shall:(1) Be an EP or an eligible hospital but not a hospital-based EP;(2) comply with sections 17b-34-1 to 17b-…

Regulations of Connecticut State AgenciesSec. 17b-34-4. Incentive Payment Requirements for Eligible ProfessionalsIn addition to meeting the requirements of section 17b-34-3 of the Regulations of Connecticut State Agencies, an EP shall meet the following requirements in order to b…

Regulations of Connecticut State AgenciesSec. 17b-34-5. Incentive Payment Requirements for Eligible HospitalsIn addition to meeting the requirements of section 17b-34-3 of the Regulations of Connecticut State Agencies, an eligible hospital shall meet the following requirements in…

Regulations of Connecticut State AgenciesSec. 17b-34-6. Methodology for Determining Patient Volume(a) Each EP and eligible hospital shall, on an annual basis, meet the applicable patient volume requirements of 42 CFR 495.304 using the methodology in 42 CFR 495.306(c). (b) Only an…

Regulations of Connecticut State AgenciesSec. 17b-34-7. Incentive PaymentsTo receive incentive payments, an EP or eligible hospital shall meet the applicable requirements under 42 CFR 495.314. The department shall make incentive payments to each eligible Medicaid provider in acco…

Regulations of Connecticut State AgenciesSec. 17b-34-8. Initial Review and Right to Request an Administrative Hearing(a) A provider aggrieved by a decision concerning only the issues set forth in 42 CFR 495.370(a) or section 17b-34(c) of the Connecticut General Statutes may reque…

Regulations of Connecticut State AgenciesSec. 17b-34-9. Audits and Documentation(a) The department may access all relevant records and documentation and take any other appropriate quality assurance measures it deems necessary to verify provider attestations or conduct pre-payment…

Regulations of Connecticut State AgenciesSec. 17b-342-1. Connecticut home care program for elders; standards for access agencies and requirements for assisted living service agencies(a) ScopeThe purpose of sections 17b-342-1 to 17b-342-5, inclusive, of the Regulations of Connecti…

Regulations of Connecticut State AgenciesSec. 17b-342-2. Services covered under the connecticut home care program for eldersThe following services are available to elders who are determined eligible for the Connecticut Home Care Program either under the criteria for the Medicaid …

Regulations of Connecticut State AgenciesSec. 17b-342-3. Service limitations, payment limitations, cost limits, waiting list and fee setting(a) Service Limitations(1) All home care services provided to individuals under the Connecticut Home Care Program shall be authorized in acc…

Regulations of Connecticut State AgenciesSec. 17b-342-4. Nursing facility and hospital requirements(a) Nursing Facility Admission RequirementsNursing Facilities shall comply with the following Connecticut Home Care Program requirements:(1) Information and Forms Distributions When…

Regulations of Connecticut State AgenciesSec. 17b-342-5. ReportingAll nursing facilities, hospitals, access agencies, assisted living service agencies, lead service providers and home care service providers shall comply with any reporting, quality assurance review and audit requi…

Regulations of Connecticut State AgenciesSec. 17b-349e-1. Scope(a) Sections 17b-349e-1 to 17b-349e-9, inclusive, of the Regulations of Connecticut State Agencies, describe administration, eligibility criteria, provider qualifications, service parameters and funding guidelines for…

Regulations of Connecticut State AgenciesSec. 17b-349e-2. PurposesThe purpose of the Connecticut Statewide Respite Care Program is to provide, within available appropriations, the following: (1) Respite care services for individuals with Alzheimer's disease residing in the commun…

Regulations of Connecticut State AgenciesSec. 17b-349e-3. DefinitionsFor the purposes of sections 17b-349e-1 to 17b-349e-9, inclusive, of the Regulations of Connecticut State Agencies, the following definitions shall apply: (1) \"Adult day health services\" means a program, of ei…

Regulations of Connecticut State AgenciesSec. 17b-349e-4. Organization and administration of program(a) The division shall oversee and regularly monitor the administration of the program as follows: (1) The division shall ensure that the first five hundred thousand dollars ($500,…

Regulations of Connecticut State AgenciesSec. 17b-349e-5. Application process(a) The application process includes all activity related to a request for a determination of eligibility under the program. The process begins with the receipt of an application by a sponsor agency and …