For Providers
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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.
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Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Medicaid
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Durable Medical Equipment (DME) Medicaid Reimbursement
The Department is revisiting reimbursement rates for Durable Medial Equipment (DME) to comply with federal regulations.
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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).
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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.
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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.
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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.
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Connecticut Medicaid Rate Setting Reimbursement and CON Unit Nursing Home Cost Reports.
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School Based Child Health (SBCH)
Medicaid School Based Child Health reimbursement information for School Districts and Providers.
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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.
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This site provides important information to health care providers about the Connecticut Medical Assistance Program. This site contains a wealth of resources for providers including enrollment, billing manuals, bulletins, program regulations, plus information on Electronic Data Interchange and the Automated Eligibility Verification System.
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Information for pharmacy and health care providers, along with others interested in pharmacy-specific program information of the CT Medical Assistance Program (CTMAP), is available on the CTMAP website. This includes an extensive variety of topics, including Preferred Drug List Information and the Pharmaceutical and Therapeutics Committee.
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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.
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Children Health Insurance Program (CHIP) State Plan Amendment
HUSKY B is Connecticut’s Children’s Health Insurance Program (CHIP, also known as Title XXI). HUSKY B provides a free or low cost health insurance program for children and youth up to age 19 for families who are not income eligible for HUSKY A.