Sec. 17b-239e. Hospital rate plan. Inpatient hospital case rate. Supplemental inpatient pool.

(a) On or before January 1, 2012, the Commissioner of Social Services, in consultation with the Commissioners of Public Health and Mental Health and Addiction Services and the Secretary of the Office of Policy and Management, shall submit to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies a plan concerning the implementation of a cost neutral acuity-based method for establishing rates to be paid to hospitals that is phased in over a period of time.

(b) The commissioner may establish a blended inpatient hospital case rate that includes services provided to all Medicaid recipients and may exclude certain diagnoses, as determined by the commissioner, if the establishment of such rates is needed to ensure that the conversion to an administrative services organization is cost neutral to hospitals in the aggregate and ensures patient access. Utilization may be a factor in determining cost neutrality. The Department of Social Services may establish, within available appropriations, a supplemental inpatient pool for certain hospitals.

(P.A. 11-44, S. 112; 11-61, S. 121; Dec. Sp. Sess. P.A. 12-1, S. 5; P.A. 13-234, S. 77; June Sp. Sess. P.A. 15-5, S. 382.)

History: P.A. 11-44 effective July 1, 2011; P.A. 11-61 amended Subsec. (b) by adding provision excluding utilization as a factor in determining cost neutrality, effective July 1, 2011; Dec. Sp. Sess. P.A. 12-1 amended Subsec. (b) to replace “shall not” with “may” and add “for the fiscal year ending June 30, 2013” re utilization as a factor in determining cost neutrality, effective December 21, 2012; P.A. 13-234 amended Subsec. (b) to add provision re supplemental inpatient pool for low-cost hospitals, and to delete “for the fiscal year ending June 30, 2013.”, effective July 1, 2013; June Sp. Sess. P.A. 15-5 amended Subsec. (b) to replace “shall” with “may” re establishment of supplemental inpatient pool and change “low cost hospitals” to “certain hospitals”, effective July 1, 2015.