Nonprofit Oversight of Medicaid Managed Care
In January 2012, Connecticut began directly reimbursing health care providers and the nonprofit Community Health Network of Connecticut, Inc. began providing care coordination and customer service for the state’s Medicaid and Children’s Health Insurance Program beneficiaries, plus members of a state-funded health program for low-income adults - about 600,000 people in all. All services are coordinated by the Department of Social Services’ Administrative Services Organization (ASO). (Source: Stateline; Community Health Network of Connecticut, Inc.)
Press Release
Request for Proposals (4/2011)
HB06518. An Act Establishing An Administrative Services Organization
Coordinated Autism Spectrum Disorder HCBS
On November 24, 2014, the Hartford Courant reported that Connecticut Medicaid is planning to begin providing HCBS to thousands of individuals under 21 who have autism spectrum disorder (ASD), starting on January 1, 2015. The Connecticut Department of Developmental Services (DDS) is working with the Department of Social Services (DSS) to draft a new plan; and the state’s Autism Spectrum Disorder Advisory Council has until December 15 to make recommendations on the proposed plan. Under the proposed plan, Medicaid would cover medically necessary evidence-based ASD services based on a diagnostic evaluation, behavior assessment, and individualized plan of care for beneficiaries under age 21. The plan would also provide care coordination and family navigator services to both children and adults with ASD. (Source: Hartford Courant, 11/24/2014)
State Demonstration to Integrate Care for Dual Eligible Individuals
Connecticut is proposing to contract with local Integrated Care Organizations (ICOs) featuring partnerships among multiple provider types facilitated by health information technology and electronic data gathering. The managed fee-for-service demonstration will serve dually Medicaid and Medicare eligibles (MMEs) 18 and older, including individuals with SMI and I/DD, with a primary focus on increasing acute health care service coordination. (Source: NASDDDS Managed Care Tracking Report; NSCLC website; Demonstration Proposal)
Balancing Incentive Program
In December 2012, CMS announced Connecticut will receive an estimated $72.8 million in enhanced Medicaid funds (a 2% enhancement of the state’s FMAP rate). (Source: CMS Balancing Incentive Program website)
CMS Award Announcement (12/7/2012)
BIP Application (10/31/2012)
BIP Structural Change Work Plan
Section 1915(i) HCBS State Plan Option
As of May 2014, CMS has approved the state’s §1915(i) HCBS State Plan Amendment; and the state is currently participating in the HCBS State Plan Option. (Source: Kaiser HCBS State Plan Option website, 5/2014)
Section 1915(k) Community First Choice Option
The state is planning to participate in the Community First Choice Option in FY 2015. On July 22, 2015, Connecticut received approval for it's CFCO State Plan Amendment (SPA). (Source: Kaiser Community First Choice website, 10/2014; Approved SPA)
On May 18, 2017, the Hartford Courant reported that a recent budget proposal would eliminate Connecticut’s share of funding for the Community First Choice Option (CFCO) program, effectively ending the initiative. Currently, 1,000 individuals are enrolled in CFCO and an additional 3,000 have applied and are awaiting a final eligibility determination. Advocates for the program argue that the program is cost effective, as it allows individuals to remain in their homes and communities and avoid costlier institutional care. The state, however, under significant financial duress, contends that the program has attracted significantly more applicants than anticipated and that it is unsustainable under current fiscal conditions. (Source: Hartford Courant 5/18/2017)
Health Homes
As of June 2014, the state has not officially submitted a Proposed Health Home State Plan Amendment to CMS, but the state plans to participate in the Health Home State Plan Option in FY 2014. (Source: CMS Health Home Proposal Status website, 6/2014; Kaiser Health Home website, 6/2014)