For Providers

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• Special for Service Partners

  Welcome to our online toolkit for partners in service to Connecticut residents eligible for the HUSKY Health program. We hope you find this content informative and useful in helping clients access and maintain eligibility.

• Person-Centered Medical Home Plus (PCMH+)

  PCMH+ provides person-centered, comprehensive and coordinated care. The purpose of this webpage is to provide PCMH+ Participating Entities with program information and updates.

• Primary Care Redesign

  The Department is conducting an evaluation and development of primary care, by engaging stakeholders. The stakeholder group is called The Primary Care Program Advisory Committee and is made up of a diverse group of stakeholders such as providers and CEOs, that represent the non-federally qualified health centers and federally qualified health centers that serve our members. The links for the recordings of the live meetings, slide decks, and meeting minutes are available on the webpage.

• Reimbursement and Certificate of Need

  The primary functions of Reimbursement and Certificate of Need (CON) include establishment of payment rates for Connecticut's Mediciad medical and residential care services, cost report auditing, and performing certificate of need reviews for nursing facilities, residential care homes, and ICF/MR development projects. Cost based rates are issued on an annual basis by the unit for services including hospitals, nursing facilities, home health care, clinics, and community residences for the elderly and disabled; as well as state-operated psychiatric hospitals, ICF/MR and federal Medicaid waiver services.

• Certificate of Need (CON)

  The Department of Social Services is responsible for the Certificate of Need (CON) process for nursing homes, residential care homes and intermediate care facilities for individuals with intellectual disabilities.

• Medicaid Methadone Clinic Reimbursement

  The Office of Reimbursement and Certificate of Need (CON) is responsible for establishing Medicaid reimbursement methodologies for chemical maintenance clinics (methadone).

• ICF IID

  Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Medicaid

• Federally Qualified Health Center (FQHC) Medicaid Reimbursement

  Federally Qualified Health Centers provide health care for uninsured and underserved populations. Reimbursement and CON is responsible for review of FQHC cost reports, and establishment of Medicaid reimbursement.

• Durable Medical Equipment (DME) Medicaid Reimbursement

  The Department is revisiting reimbursement rates for Durable Medial Equipment (DME) to comply with federal regulations.

• Online Hospital Notification of Newborn

  ***Hospital Use Only*** Please use this online form to submit the hospital notification of newborn information to DSS.

• Medicaid Hospital Reimbursement

  The Office of Reimbursement and Certificate of Need (CON) is responsible for establishing Medicaid reimbursement methodologies for inpatient services, outpatient hospital services, Disproportionate Share Hospital (DSH) payments and hospital supplemental payments.

• Medicaid Nursing Home Reimbursement

  Under the Connecticut Medicaid program, payment rates for nursing homes are set on a cost-based prospective basis in accordance with Section 17b-340 of the Connecticut General Statutes and Section 17-311-52 of the Regulations of Connecticut State Agencies.

• Medicaid Nursing Home Reimbursement Modernization Acuity Based Methodology

  The Connecticut Department of Social Services (DSS) will be transitioning nursing facility reimbursement from a cost-based methodology to a prospective acuity-based or case mix, payment system. Visit this webpage for more information.

• Nursing Facility Cost Reports

  Connecticut Medicaid Rate Setting Reimbursement and CON Unit Nursing Home Cost Reports.

• Birth to Three

  Medicaid Reimbursement information for the Birth to Three program.