For Providers

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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.

• Nursing Facility Cost Reports

  Connecticut Medicaid Rate Setting Reimbursement and CON Unit Nursing Home Cost Reports.

• Online Hospital Notification of Newborn

  ***Hospital Use Only*** Please use this online form to submit the hospital notification of newborn information to DSS.

• PCA CERTIFICATION TEST

• Person-Centered Medical Home Plus (PCMH+)

  PCMH+ provides person-centered, comprehensive and coordinated care. The purpose of this webpage is to provide PCMH+ Participating Entities with program information and updates.

• Primary Care Redesign

  The Department is conducting an evaluation and development of primary care, by engaging stakeholders. The stakeholder group is called The Primary Care Program Advisory Committee and is made up of a diverse group of stakeholders such as providers and CEOs, that represent the non-federally qualified health centers and federally qualified health centers that serve our members. The links for the recordings of the live meetings, slide decks, and meeting minutes are available on the webpage.

• 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 Home and Community-Based Services (HCBS)

• Residential Care Homes (RCH)

  Connecticut Residential Care Homes rates are set in accordance with state regulation. Cost reports for privately operated facilities are also used for rate setting purposes.

• School Based Child Health (SBCH)

  Medicaid School Based Child Health reimbursement information for School Districts and Providers.

• Special for Service Partners

  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.