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Reimbursement and Certificate of Need

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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.

  • Reimbursement and Certificate of Need - Federally Qualified Health Center (FQHC)

    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.

  • Certificate of Need (CON)

    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.

  • Medicaid Chemical Maintenance Clinics

    The Office of Reimbursement and Certificate of Need (CON) is responsible for establishing Medicaid reimbursement methodologies for chemical maintenance clinics (methadone).

  • Durable Medical Equipment (DME) Medicaid Reimbursement

    The Department is revisiting reimbursement rates for Durable Medial Equipment (DME) to comply with federal regulations.