Medicaid Access Monitoring Review Plan

Overview

 New Federal Medicaid Access Regulations

Effective January 1, 2016, the federal Centers for Medicare & Medicaid Services (CMS) adopted regulations at 42 C.F.R. §§ 447.203 and 447.204 that require state Medicaid programs to ensure Medicaid members have access to covered services. Please follow this link Opens in a new window Opens in a new window Opens in a new window to read the federal regulations. The Department of Social Services (DSS), which administers Medicaid in Connecticut, is committed to ensuring that Medicaid members can access the services they need. DSS is also committed to complying with the federal access requirements.

 Medicaid Access Plan

The federal access regulations require DSS to prepare an access monitoring review plan (“access plan”), which must analyze how Medicaid members have access to medically necessary covered services, including analysis of data sources, methodologies, baselines, assumptions, trends, factors, and thresholds. States must also consider information about access from providers, members, and other stakeholders.

This webpage provides information only about the access plan. This page is not designed to fix immediate access problems (see phone numbers below if you are a Medicaid member who needs help finding a doctor or other provider). Please do not send any personally sensitive information such as social security numbers or Medicaid ID numbers with your comments about the access plan. Please follow the links below to read the final Access Monitoring Review Plan and Appendix 1 of the plan. 

Access Monitoring Review Plan Opens in a new window Opens in a new window

Appendix 1

Appendix 2 Opens in a new window Opens in a new window

 

Medicaid Members Who Need Help Finding a Doctor or Other Provider

If you are a Medicaid member who needs help finding a doctor or other provider right now, please contact member services on your Medicaid card or one of the following:

  • For Help Finding a MEDICAL provider, please contact HUSKY Health / Community Health Network (CHNCT) Call 1-800-859-9889 (or 711 if you are hearing impaired), open Monday - Friday 8:00 a.m. – 6:00 p.m. Or visit the HUSKY Health website at www.huskyhealth.com
  • For Help Finding a BEHAVIORAL HEALTH provider, please contactCT Behavioral Health Partnership / Beacon Health Options CT Call 1-877-552-8247 (TTY: 1-866-218-0525), open Monday -Friday 9:00 a.m. – 7:00 p.m. Or visit the CT Behavioral Health Partnership website at www.ctbhp.com
For Help Finding a DENTAL Provider, pleaser contact CT Dental Health Partnership / BeneCare Call 1-855-283-3682, open Monday - Friday 8:00 a.m. -5:00 p.m. Or visit the CT Dental Health Partnership website: www.ctdhp.com