Medicaid Nursing Home Reimbursement

Laws/Regulations/Communication

Public Act No. 14-55 Opens in a new window
Public Act No. 14-55 Related Party Annual Profit / Loss Statements
Public Act No. 15-36 - Cost Reporting Deadlines for Long Term Care Facilities Amended Pages to Annual Report of Long-Term Care Facility
Notice regarding Patient Needs / Resident Trust Fund Account
Regulations

Medicaid State Plan Amendments
The state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities. When a state is planning to make a change to its state plan, the state must send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, change reimbursement methods, or update their Medicaid or CHIP state plan with new information. Connecticut Medicaid State Plan Amendments submitted to the Centers for Medicare & Medicaid Services (CMS) within the U.S. Department of Health and Human Services (HHS) are available through the Department website.

Semi-annual Accounts Payable (AP) Reports
Effective January 1, 2024, the Medicaid Provider Agreement was amended to include a requirement that nursing homes are to submit semi-annual accounts payable (AP) reports not later than September 30th and March 31st every year to the Department. The reports should reflect the most recent accounts payable schedule for your nursing home. Additional information is available through the Department memo.

Additional Information, Industry and Department Letters

Money Follows the Person Financial Advisory Committee Presentation April 12, 2023
LTC Planning Committee Rebalancing Calculation Categories April 12, 2023

DSS Letter to Industry Nursing Home Quality Program Withhold February 23, 2023

November 30, 2022 CAHCF/CCAL Letter to Commissioner
January 11, 2023 Department Response

May 19, 2022 CAHCF/CCAL Letter to Commissioner
May 20, 2022 LeadingAge Connecticut Letter
July 7, 2022 Department Response