**Connecticut Medicaid (HUSKY A, C and D) members can receive free rides to and from their scheduled COVID-19 vaccination appointments with 48 hours’ notice through Veyo, the state contractor for non-emergency medical transportation. Members who need a ride should call the Veyo Contact Center at 855-478-7350 (toll-free).

For special information and resources for HUSKY Health members about coronavirus (COVID-19), including the Nurse Helpline, www.ct.gov/husky/covidinfoformembers. For special information for HUSKY Health providers, please visit www.ct.gov/husky/covidinfoforproviders.

**Your HUSKY Health coverage will be extended automatically for the duration of the public health emergency, as long as you are a Connecticut resident and want coverage. We are automatically extending your coverage as part of the State of Connecticut’s response to the coronavirus pandemic. Even though coverage will be extended, if you get a renewal form we ask that you complete it in order to get the longest possible coverage period. We appreciate your patience as we work to ensure our systems are updated to reflect your continued enrollment status.**

Important information for HUSKY Health Providers

HUSKY Health is responding to member and provider needs associated with COVID-19 by developing and issuing various pieces of guidance that are intended to provide flexibility in ensuring that members are effectively served and minimize risk of exposure for both members and providers.  Unless otherwise specified below, all of this guidance is effective during the period of the COVID-19 public health emergency.

While DSS will continue to post these bulletins on the www.ctdssmap.com site in the provider section and circulate through ‘Important Messages,’ please see below for an inventory and brief summaries of these provider bulletins that will be updated on a rolling basis as new information is released.  Please see the last page of each bulletin for an identified point of contact for questions.

Index:

- HUSKY B Co-Payments
- HUSKY Health Extended Care Clinics
- HUSKY Health Home and Community-Based “Waiver” Coverage
- HUSKY Health Lab Testing for COVID-19
- HUSKY Health Pharmacy Coverage
- HUSKY Health Telemedicine Coverage

Department of Social Services offering Medicaid coverage for uninsured during COVID-19 public health emergency 

The Connecticut Department of Social Services is providing COVID-19 testing coverage for uninsured children and adults in the HUSKY Health program as part of the state’s response to the COVID-19 public health emergency.  This includes:

  • Medicaid for the Uninsured/COVID-19:  Uninsured state residents of any income level may be eligible for free Medicaid coverage of COVID-19 testing and testing-related provider visits.  This new federally-funded Medicaid coverage group will cover both citizens and qualifying non-citizens for testing and testing-related provider visits incurred between March 18, 2020 and the end of the public health emergency.  HUSKY Health providers are advised to retain records regarding COVID-19 testing and testing-related provider visits for eligible individuals, starting March 18 and through the duration of the public health emergency, for purposes of Medicaid reimbursement.  Individuals who received care on or after March 18 and were eligible for coverage at the time services were provided will be able to receive retroactive coverage.

    Please access the initial bulletin at:  https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20_42.pdf&URI=Bulletins/PB20_42.pdf
  • Emergency Medicaid for Non-Citizens/COVID-19:  Connecticut residents who meet financial eligibility requirements but do not qualify for full Medicaid due to their immigration status, including undocumented individuals, are eligible to receive Medicaid to treat an emergency medical condition.  COVID-19 testing and testing-related provider visits are emergency visits that will be covered by Emergency Medicaid.  Emergency Medicaid is not a factor in federal immigration ‘public charge’ determinations.  Individuals who received care within the prior three months and were eligible for coverage at the time services were provided will be able to receive retroactive coverage.  HUSKY Health providers are advised that coverage for hospitalization will be handled through existing processes for Emergency Medicaid coverage.

    Please access the initial bulletin at:  
    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20_43.pdf&URI=Bulletins/PB20_43.pdf

HUSKY B (Children’s Health Insurance Program) Co-Payments

DSS has released two bulletins that include information about waiver of HUSKY B copayments.

HUSKY Health Extended Care Clinics (ECCs)

DSS has issued a provider bulletin that suspends various requirements for Enhanced Care Clinics.  ECCs Enhanced Care Clinics (ECC’s) are specially designated Connecticut-based mental health and substance abuse clinics that serve adults and/or children. They provide routine outpatient services such as individual therapy, group therapy, family therapy, medication management, and coordination of care with primary care physicians, and other special services for CT BHP members.
 
Specifically, for the period of the public health emergency, the bulletin:

  • waives the time requirements for responding to urgent and emergent cases;
  • permits clinics to merge without following the process outlined to consolidate staff; and
  • waives the requirement for extended operating hours.

Please see the bulletin here:

https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20-19.pdf&URI=Bulletins/PB20-19.pdf

HUSKY Health Home and Community-Based Waiver Coverage

DSS has issued a bulletin that outlines Appendix K public health emergency flexibilities for Connecticut’s home and community-based (HCBS) waiver providers.  Generally, these include virtual visits, service options, and relaxing certain procedural requirements.

Please see the bulletin at this link:

https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20_27.pdf&URI=Bulletins/PB20_27.pdf

On behalf of its sister agencies DMHAS and DDS, DSS submitted Appendices K for all of the approved Connecticut waivers on March 25, 2020, and they were approved by CMS on the 27th.

Please see below for a summary. 

  • ALL CONNECTICUT WAIVERS

    • Allow virtual assessments and reassessments, waiving the face-to-face requirement
    • Suspend required timelines for task completion, in particular for reassessments, for the duration of the emergency
    • Waive written signature affirming agreement with person-centered care plan and replacing with documentation of verbal agreement
    • Permit substitution of lower level staff in a service plan, such as substituting a companion for a homemaker
    • Permit increase in individual cost limits if needed to support members in the community safely.  Exceptions to the individual cost cap will be reviewed and approved by Community Options clinical staff.
  • DDS Waivers

    • Permit exceptions to background checks for self-directed service providers
    • Pay self-directed workers during member hospitalization associated with COVID19 for up to 30 days
    • Extend time period to complete required provider training time frame from 90 to 180 days for Individualized Home Supports, Personal Supports, Individualized Day Supports
    • Add home-delivered meals as a service for individuals in their own home
    • Permit guardian and legally liable relatives to provide for Individualized Home Supports, Personal Supports, Individualized Day Supports
    • Permit retainer payments for all residential and day programs to ensure continuous operations
    • Permit waiver services to be provided out of state (primarily this is if providers need to relocate to a home across state line

    DDS Comprehensive and Individual and Family Support Waivers

    • Increase bed capacity for Continuous Residential Services
    • Provide Individualized Home Support as a group services,  telephonically, or virtually
    • Provide Personal Supports as a group, telephonically, or virtually
    • Provide Day Support Options in the home, telephonically, or virtually
    • Provide Senior Support in the home or virtually
    • Provide Individualized Supported Employment in the home, telephonically, or virtually
    • Provide Individualized Day Supports in the home, telephonically, or virtually
    • Provide Transitional Employment Services in the home, telephonically, or virtually
    • Provide Prevocational in home
    • Provide Group Supported employment  in home
    • Provide Behavioral supports via telephonically, or virtually Provide Senior Supports provided virtually
    • Permit payment for  Individualized Home Supports, Personal Supports or Individualized Day Support rendered by guardian or legally responsible individuals

    DDS Employment and Day Support Waiver

    • Provide Day Support Options in the home, telephonically, or virtually
    • Provide Individualized Supported Employment in the home, telephonically, or virtually
    • Provide Individualized Day Supports in the home, telephonically, or virtually
    • Provide Transitional Employment Services in the home, telephonically, or virtually
    • Provide Group Supported employment in home
    • Provide Behavioral supports via telephonically, or virtually Provide Senior Supports provided virtually
    • Permit payment Individualized Day Support rendered by guardian or legally responsible individuals.
  • Mental Health Waiver

    • Modify the service definitions of both Recovery Assistant and Community Support Programs to allow for non-face to face service provision, including up to 2 hours of telephonic check-ins to determine current status and needs of a client, and assistance in obtaining needed goods and provisions
    • Permit substitution of Community Support Program providers and Recovery Assistants, with approval and when necessary in order to maximize use of available staffing resources
  • Acquired Brain Injury Waivers 1 and 2

    • Eliminate 18 hour daily limit for companion service
    • Permit family members to provide companion services
    • Waive initial brain-injury specific training requirement as a precondition of employment, and also make the training available virtually
    • For ABI 1 only, add Agency PCA as a waiver service
    • Permit Companion service to be provided electronically or telephonically for up to two hours per day
  • Connecticut Home Care Program for Elders Waiver
    • Permit family members to provide companion services
    • Permit Mental health Counseling and Adult Day Health to be provided electronically or telephonically.  Adult Day providers will contact each client daily and will also deliver two meals daily
  • PCA Waiver
    • Permit non legally liable family members to provide personal care in the event of caregivers not being available
    • Mental health counseling and Adult Day health Services may be provided electronically or telephonically.
    • Add home-delivered meals.
  • Autism Waiver
    • Life Coach services may be provided electronically or telephonically, with approval from the care manager


HUSKY Health COVID-19 Lab Testing:

DSS has released a bulletin that outlines coverage of laboratory testing for COVID-19, using CDC/CMS identified HCPCS codes.  Please note that that HUSKY Health members are not required to make co-payments for any HUSKY Health service, including, but not limited to, COVID-19 testing and treatment.

Please access this bulletin at this link:

https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_12.pdf&URI=Bulletins/pb20_12.pdf

HUSKY Health Pharmacy Coverage

DSS has released a provider bulletin that indicates that details that DSS is:

  • waiving the monthly Medicare Part D co-payments that individuals who are dually-eligible for Medicare and Medicaid are required to pay
  • modifying the HUSKY Health early refill policy for prescriptions so that prescriptions can be refilled if 80% of the medication has been used
  • modifying the “maximum allowable unit and days’ supply” policy for prescriptions of maintenance and non-maintenance drugs, other than controlled substances, to permit 90- day supplies of medication

Please access this bulletin at this link:

https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20_13.pdf&URI=Bulletins/PB20_13.pdf


HUSKY Health Telemedicine Coverage

DSS is continuing to release updates to its telemedicine coverage.  Please check back to this page frequently for updates.

PERMANENT COVERAGE OF TELEMEDICINE UNDER HUSKY HEALTH

Medical and Behavioral Health Services

A provider bulletin outlines new permanent coverage of real-time video conferencing between HUSKY Health members and their health care providers for specific medical and behavioral health services.  This guidance remains effective beyond the period of the COVID-19 public health emergency.

This bulletin outlines coverage for the following, when medically necessary (consistent with the statutory definition at Conn. Gen. Stat. 17b-259b) and compliant with all otherwise applicable requirements were the service to be performed face-to-face:

  • Behavioral health telehealth services are payable for:
    • members receiving specified psychotherapy services
    • members receiving Medication Assisted Therapy (MAT) services
    • select Evaluation & Management services
    • individual smoking cessation

     

  • Medical telehealth services (select Evaluation & Management services, individual smoking cessation, health and behavior assessment/intervention) are payable for:
    • members who have been determined to be homebound by their physician, advanced practice registered nurse (APRN), certified nurse midwife (CNM), physician assistant (PA) or podiatrist
    • members who have been approved to have or have received surgery from a provider located in non-contiguous state (i.e., any state that does not border Connecticut)

    Please access this bulletin at this link:

    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_09.pdf&URI=Bulletins/pb20_09.pdf

    Telemedicine for Home Health and Hospice

    A bulletin further expands telemedicine to permit home health and hospice agencies to perform specified services, as detailed below:

    • Home Health agencies are authorized to provide 1) medication administration via videoconferencing or audio-only calls; and 2) select therapy services via videoconferencing only.
    • Hospice agencies are authorized to perform eligible services via videoconferencing or audio-only calls, so long as all other applicable requirements are met for the involved services. 
    • DSS is suspending Electronic Visit Verification for select medication administration services and select therapy services for the duration of the public health emergency.

    Please see the bulletin at this link:
    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_28.pdf&URI=Bulletins/pb20_28.pdf 

    Remote Early Intervention Under Birth to Three

    A provider bulletin adds new permanent coverage for Remote Early Intervention (EI) under specified circumstances. This is designed to address specific access constraints in the Birth to Three System, especially for children located far from hearing specialty providers and also to provide services more readily to children with compromised immune systems.

    Please access the bulletin at this link:

    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_16.pdf&URI=Bulletins/pb20_16.pdf

    COVID-SPECIFIC COVERAGE OF TELEMEDICINE UNDER HUSKY HEALTH

    All of the below guidance is effective for the duration of the COVID-19 public health emergency.

    Medical and Behavioral Health Services

    DSS has released additional COVID-19 specific guidance for medical and behavioral health via telemedicine.

    • A bulletin authorizes providers to provide the following evaluation and management (E/M) services for medical and behavioral health via videoconferencing.  

    table of procedure codes

    Please access this bulletin at this link:

  • A bulletin further expands telemedicine coverage to include additional codes and audio-only telephone visits.

    This includes:

    • Use of audio/video conferencing for:
      • all children's behavioral health rehabilitation services
      • autism spectrum disorder treatment services
      • targeted case management
      • standard case management
      • family therapy without the patient

    • Use of audio-only telephone visits for medical and behavioral health E&M codes and all behavioral health services referenced in all previously released bulletins.  This is for calls of minimum length (11-20 minutes, 21-30 minutes) between identified providers and established patients who have given, at a minimum, verbal informed consent that is documented in the EMR, for purposes of medical discussion of a clinical service, using CPT guidance for billing, utilizing applicable fee schedules, and prohibiting this use for initial induction of MAT and routine, non-clinical telephone communication.

    Please access this bulletin at this link:

    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20_14.pdf&URI=Bulletins/PB20_14.pdf

     

Rehabilitation Clinic and Physical, Occupational and Speech and Language Pathology Therapies

  • A bulletin further expands telemedicine coverage to include Rehabilitation Clinic services.This includes coverage for the following Physical Therapy (PT), Occupational Therapy (OT), and Speech and Language Pathology (SLP) codes:
  • 97010-97022, 97533 - These codes are for PT/OT services, are considered supervised codes, and do not require one-on-one patient contact per CPT manual.
  • 97110-97130 - These codes are for PT/OT services.
  • 92507, 92521, 92522 - These codes are for SLP services and do not require one-on-one patient contact.

Please access this bulletin at this link:

https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_24.pdf&URI=Bulletins/pb20_24.pdf

  • A bulletin further expands telemedicine services to include specified PT, OT and speech and SLP services.The procedure codes in this proposal are the same as those referenced above under Rehabilitation Clinic but also include procedure code 96125 - standardized cognitive performance testing to OP hospitals and OP CDHs, payable to them only.

    Please access the bulletin at this link:

    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_23.pdf&URI=Bulletins/pb20_23.pdf

    Group Psychotherapy, Intermediate Levels of Care and Autism Spectrum Disorder Services

    A bulletin further expands telemedicine to include Group Psychotherapy, Intermediate Levels of Care and Autism Spectrum Disorder services provided by behavioral health clinicians, behavioral health clinics, and outpatient hospitals via synchronized telemedicine only (not audio-only telephone).

    Please access the bulletin at this link:

    https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=PB20_25.pdf&URI=Bulletins/PB20_25.pdf

    Remote Early Intervention Under Birth to Three

    A bulletin temporarily expands the scope of Remote Early Intervention (EI) by:

    • broadening remote EI to all categories of Early Intervention Services (EIS)
    • removing these and other procedural requirements:
      • prior authorization to provide Remote EI
      • documentation of EI be listed in the child’s Individualized Family Service Plan (IFSP)
    • enables Remote EI to be provided by audio-only telephone in specified limited circumstances

Please access the bulletin at this link:

https://www.ctdssmap.com/CTPortal/Information/Get%20Download%20File/tabid/44/Default.aspx?Filename=pb20_17.pdf&URI=Bulletins/pb20_17.pdf

CMS has approved the following aspects of Connecticut’s Section 1135 submissions:

  • Waiver of various prior authorization requirements;
  • Flexibilities to enroll new providers and to defer provider enrollment revalidation;
  • Authority to provide care in alternative settings (e.g., shelter, vehicle), and;
  • Certain modifications to fair hearing requirements. 

Further, CMS indicated that ‘blanket waivers’ issued at the federal level authorize the state to take actions including increasing the bed capacity in various health care settings and maximizing Medicare coverage of nursing facility stays.  Other requests made by the Department are still pending CMS approval.