Sec. 17b-294a. HUSKY Plus program. Administration. Eligibility. Regulations.

(a) The commissioner shall, within available appropriations, establish a supplemental health program to be known as HUSKY Plus for HUSKY B members whose medical needs cannot be accommodated within the basic benefit package offered to members. The HUSKY Plus program shall supplement coverage for those medically eligible members with intensive physical health needs.

(b) Within available appropriations, the commissioner shall contract with one or more entities to (1) administer and operate the HUSKY Plus program, and (2) conduct an external quality review of the HUSKY Plus program not later than July 1, 2017.

(c) The service benefit package shall be supplemental to HUSKY B services and shall include powered wheelchairs. If a provider is not enrolled in the medical assistance program, the provider shall accept the medical assistance program rates as payment in full and such other conditions as the commissioner may specify.

(d) Not later than July 1, 2017, the commissioner shall adopt regulations, in accordance with chapter 54, to (1) establish criteria and specify services for the HUSKY Plus program, and (2) establish a procedure for the appeal of a denial of coverage under the HUSKY Plus program. Such regulations shall state that the HUSKY Plus program shall give priority in such program to members with household incomes at or below two hundred forty-nine per cent of the federal poverty level.

(e) On and after the date on which any medically eligible member begins receiving benefits under the HUSKY Plus program, such member shall not be eligible for services under Title V of the Social Security Act, with the exception of respite care services.

(f) As used in this section, “medically eligible member” means any member with intensive physical health needs whose medical needs cannot be met within the HUSKY B benefits offered to members.

(June Sp. Sess. P.A. 10-1, S. 33; P.A. 15-69, S. 26; P.A. 16-19, S. 1.)

History: June Sp. Sess. P.A. 10-1 effective July 1, 2010; P.A. 15-69 amended Subsec. (a) to replace provisions re 2 supplemental health insurance programs known as HUSKY Plus programs with provisions re a supplemental health program known as HUSKY Plus and replace references to HUSKY Plan, Part B with references to HUSKY B, amended Subsec. (b) to delete provision re medically eligible enrollees, deleted former Subsecs. (c), (e) and (i) and redesignated existing Subsecs. (d), (f), (g), (h), (j) and (k) as Subsecs. (c) to (h), amended redesignated Subsec. (d) to delete former Subdiv. (2) re appeal of denial of coverage, amended redesignated Subsec. (e) to delete provision re report, amended redesignated Subsec. (g) to changes “incomes at or below two hundred thirty-five per cent” to “incomes at or below two hundred forty-nine per cent”, amended redesignated Subsec. (h) to change “medically eligible enrollee” to “medically eligible member” and redefine term, and made technical and conforming changes, effective June 19, 2015; P.A. 16-19 amended Subsec. (a) to delete reference to subsidized portions of HUSKY B, amended Subsec. (b) to add “one or more”, delete provisions re program under Title V of Social Security Act, designate existing provision re entities to administer and operate HUSKY Plus program as Subdiv. (1) and add Subdiv. (2) re external quality review of HUSKY Plus program, substantially amended Subsec. (c) to replace provisions re program consistency with Title V of Social Security Act and add provision re provider's acceptance of medical assistance program rates, amended Subsec. (d) to delete former Subdivs. (1) and (2) re regulations provisions re appeal, add new Subdiv. (1) re regulations to establish criteria and specify services for HUSKY Plus program, designate provision re establishment of appeal procedure as Subdiv. (2) and add provision re regulations to state HUSKY Plus program priority for certain households, deleted former Subsec. (e) re contract for external quality review, redesignated existing Subsec. (f) as Subsec. (e) and amended same to add reference to respite care services, deleted former Subsec. (g) re adoption of regulations for HUSKY Plus program, and redesignated existing Subsec. (h) as Subsec. (f) and amended same to redefine “medically eligible member”, effective May 6, 2016.