This bill, sSB1110 File No. 443, makes several changes to current law regarding health insurance policies and the payment of claims for health care items or services covered under state medical assistance programs. It changes the timeframe for insurers or other legally liable third parties to make payment on a claim submitted by the department or its designee. It also requires insurers or other legally liable third parties to request any refund from the department within 12 months from the date of their reimbursement to the department if they determine they are not liable and at risk for the cost of the health care item or service.

The bill also makes changes to the Connecticut energy assistance program. It requires the Commissioner of Social Services to implement a program to purchase deliverable fuel for low-income households participating in the program. The commissioner must ensure an adequate supply of vendors for the program by establishing pricing standards, reimbursing fuel providers based on the price of fuel on the date of delivery, establishing a discount on the vendor's retail price, and allowing vendors to electronically submit fuel slips or invoices for payment. The bill also requires community action agencies administering the fuel assistance program to submit reports on pricing information from fuel vendors participating in the program. Additionally, the bill allows the Commissioner of Social Services to implement a bundled payment or other alternative payment methodologies for maternity services under the state Medicaid program. The commissioner may implement policies and procedures without adopting regulations, as long as notice of intent to adopt regulations is published within twenty days of implementation. The bill also repeals and replaces the definition of vendor fraud and expands eligibility for state-funded medical assistance to children twelve years of age and younger, regardless of immigration status, whose household income does not exceed two hundred one percent of the federal poverty level.

Statutes affected:
Raised Bill:
HS Joint Favorable Substitute:
File No. 443: