The goal of the program was to reduce costs and inappropriate utilization of medical services, and increase access to care for Medicaid recipients. The plan was to phase Medicaid beneficiaries into managed care, beginning with the AFDC population. As of November 2000, the State did not plan to enroll the SSI population. In 1995, the state selected health plans using the any willing approach whereby any health plan that could meet the state s contractual requirements was allowed to bid on the contract. However, beginning in 1998 the State initiated a competitive bidding approach by issuing a Request for Applications to select plans based on price and quality criteria.
All plans receive capitated payments for both inpatient and outpatient services.
At the direction of the legislature, a competitive bidding process was used to develop rates for the upcoming contract renewal process with participating health plans. The Medicaid managed care program operates statewide. Persons who are members of the TANF group as well as poverty level pregnant women and children, and children in foster care must enroll in Connecticut Access. Upon eligibility determination for Medicaid, beneficiaries are asked to select a plan. If they fail to choose a plan within 30 days they are randomly assigned to a managed care plan.