Substitute Senate Bill No. 985 introduces significant changes to the oversight and management of the HUSKY Health Program in Connecticut, particularly regarding the Medicaid reimbursement and care delivery model. The bill mandates that any transition from a fee-for-service model to a managed care model must receive legislative approval, requiring the Commissioner of Social Services to submit proposals to the relevant joint standing committees of the General Assembly. These committees are tasked with holding public hearings and providing feedback on the proposals, and if consensus is not reached, a committee of conference will be formed to resolve disagreements. Additionally, the bill establishes new reporting requirements for the Commissioner, who must file annual reports on the financial performance and quality of care within the Medicaid program.

The bill also revamps the composition and responsibilities of the Council on Medical Assistance Program Oversight, introducing new members to ensure diverse representation, including advocates for Medicaid recipients and individuals with substance use disorders. It emphasizes the council's role in monitoring Medicaid care management initiatives, enrollment processes, and provider network sufficiency. Furthermore, the bill allows for the creation of pilot programs aimed at providing comprehensive health insurance coverage for specific populations, while also modifying confidentiality regulations to protect sensitive information. Overall, the bill seeks to enhance oversight, accountability, and stakeholder involvement in the management of Medicaid services in Connecticut, with an effective date set for July 1, 2025.

Statutes affected:
Committee Bill:
HS Joint Favorable Substitute:
File No. 165: