reglab/housing_qa huggingface dataset:
CT Gen Stat § 17b-261o (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-261o - Imposition of penalty period when undue hardship exists. Exception.

 (a) Except as provided in subsection (c) of this section, the Commissioner of Social Services shall not impose a penalty period pursuant to subsection (a) of section 17b-261 or subsection (a) of section 17b-261a if such imposition would create an undue hardship.(b) For purposes of this section, “undue hardship” exists when (1) the life or health of the applicant would be endangered by the deprivation of medical care, or the applicant would be deprived of food, clothing, shelter or other necessities of life, (2) the applicant is otherwise eligible for medical assistance under section 17b-261 but for the imposition of the penalty period, (3) if the applicant is receiving long-term care services at the time of the imposition of a penalty period, the provider of long-term care services has notified the applicant that such provider intends to discharge or discontinue providing long-term care services to the applicant due to nonpayment, (4) if the applicant is not receiving long-term care services at the time of the imposition of a penalty period, a provider of long-term care services has refused to provide long-term care services to the applicant due to the imposition of a penalty period, and (5) no other person or organization is willing and able to provide long-term care services to the applicant.(c) The commissioner shall impose a penalty period pursuant to subsection (a) of section 17b-261 or subsection (a) of section 17b-261a if (1) the applicant made a transfer or assignment of assets to deliberately impoverish such applicant in order to obtain or maintain eligibility for medical assistance, or (2) the transfer or assignment of assets was made by the applicant's legal representative or the joint owner of the assets. The commissioner may waive the imposition of a penalty period pursuant to this subsection if (A) the applicant suffers from dementia or other cognitive impairment and cannot explain the transfer or assignment of assets, (B) the applicant suffered from dementia or other cognitive impairment at the time the transfer or assignment of assets was made, (C) the applicant was exploited into making the transfer or assignment of assets due to dementia or other cognitive impairment, or (D) the applicant's legal representative or the record owner of a jointly held asset made the transfer or assignment of assets without the authorization of the applicant.(P.A. 11-176, S. 1.)History: P.A. 11-176 effective July 1, 2011.
CT Gen Stat § 17b-261q (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-261q - Action by nursing home facility to collect debt for unpaid care provided during penalty period.

 (a) For purposes of this section and sections 17b-261r and 17b-261s, (1) “nursing home facility” means a chronic and convalescent nursing home and a rest home with nursing supervision, and (2) “penalty period” means the period of Medicaid ineligibility imposed pursuant to 42 USC 1396p(c), as amended from time to time, on a person whose assets have been transferred for less than fair market value for the purposes of obtaining or maintaining Medicaid eligibility.(b) Any transfer or assignment of assets resulting in the establishment or imposition of a penalty period shall create a debt, as defined in section 36a-645, that shall be due and owing to a nursing home facility for the unpaid cost of care provided during the penalty period to a nursing home facility resident who has been subject to the penalty period. The amount of the debt established shall not exceed the fair market value of the transferred assets at the time of transfer that are the subject of the penalty period.(c) The provisions of this section shall not affect other rights or remedies of the parties. A nursing home facility may bring an action to collect a debt for unpaid care given to a resident who has been subject to a penalty period, provided (1) the debt recovery does not exceed the fair market value of the transferred asset at the time of transfer, and (2) the asset transfer that triggered the penalty period took place not earlier than two years prior to the date of the resident's Medicaid application. The nursing home facility may bring such action against (A) the transferor, or (B) the transferee.(d) In actions brought under subsection (c) of this section, a court of competent jurisdiction may award actual damages, court costs and reasonable attorneys' fees to a nursing home facility if such court determines, based upon clear and convincing evidence, that a defendant incurred a debt to a nursing home facility by (1) wilfully transferring assets that are the subject of a penalty period, (2) receiving such assets with knowledge of such purpose, or (3) making a material misrepresentation or omission concerning such assets. Court costs and reasonable attorneys' fees shall be awarded as a matter of law to a defendant who successfully defends an action or a counterclaim brought pursuant to this section. Any court, including a probate court acting under subdivision (3) of subsection (a) of section 45a-98 or section 45a-364, may also order that such assets or proceeds from the transfer of such assets be held in constructive trust to satisfy such debt.(e) The provisions of this section shall not apply to a conservator who transfers income or principal with the approval of the Probate Court under subsection (d) or (e) of section 45a-655.(P.A. 13-234, S. 128.)
CT Gen Stat § 17b-261s (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-261s - Copy of complaint, judgment or decree to be mailed in action by nursing home facility.

 Upon commencement of any action brought under section 17b-261q or 17b-261r, a nursing home facility shall mail a copy of the complaint to the Attorney General and the Commissioner of Social Services and, upon entry of any judgment or decree in the action, shall mail a copy of such judgment or decree to the Attorney General and the Commissioner of Social Services.(P.A. 13-234, S. 130.)
CT Gen Stat § 17b-261t (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-261t - Contents of Medicaid benefits cards.

 Section 17b-261t is repealed, effective July 2, 2015.(P.A. 14-62, S. 2; P.A. 15-165, S. 3.)
CT Gen Stat § 17b-261u (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-261u - Alternate coverage after loss of Medicaid eligibility for parent or needy caretaker relative. Review. Quarterly reports.

 (a) The Commissioner of Social Services shall review whether a parent or needy caretaker relative, who qualifies for Medicaid coverage under Section 1931 of the Social Security Act and is no longer eligible on and after August 1, 2015, pursuant to section 17b-261, remains eligible for Medicaid under the same or a different category of coverage before terminating coverage.(b) The commissioner and the Connecticut Health Insurance Exchange, established pursuant to section 38a-1081, shall ensure that such parent or needy caretaker relative is given an opportunity to enroll in a qualified health plan without a gap in coverage. The Connecticut Health Insurance Exchange shall enlist the assistance of health and social services community-based organizations to contact and advise such parent or needy caretaker relative of options for health insurance coverage.(c) Not later than November 1, 2015, and quarterly thereafter until December 1, 2017, the commissioner and the Connecticut Health Insurance Exchange shall report to the Council on Medical Assistance Program Oversight on the number of such parents and caretaker relatives who, due to changes in income eligibility effective August 1, 2015, (1) were no longer eligible for Medicaid, (2) remained eligible after the commissioner's review pursuant to this section, (3) lost Medicaid coverage and enrolled in a qualified health plan without a gap in coverage, (4) lost Medicaid coverage and did not enroll in a qualified health plan immediately after such coverage loss, and (5) enrolled in a qualified health plan but were disenrolled for failure to pay premiums.(June Sp. Sess. P.A. 15-5, S. 371.)History: June Sp. Sess. P.A. 15-5 effective June 30, 2015.
CT Gen Stat § 17b-261v (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-261v - Parent or needy caretaker relative. Review of Medicaid coverage options.

 The Commissioner of Social Services shall review whether a parent or needy caretaker relative, who qualifies for Medicaid coverage under Section 1931 of the Social Security Act and is no longer eligible on and after January 1, 2018, remains eligible for Medicaid under the same or a different category of coverage before terminating coverage.(June Sp. Sess. P.A. 17-2, S. 139.)History: June Sp. Sess. P.A. 17-2 effective January 1, 2018.
CT Gen Stat § 17b-262. (Formerly Sec. 17-134d) (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-262. (Formerly Sec. 17-134d) - Regulations. Admissions to nursing home facilities.

 The Commissioner of Social Services may make such regulations as are necessary to administer the medical assistance program. Such regulations shall include provisions requiring the Department of Social Services (1) to monitor admissions to nursing home facilities, as defined in section 19a-521, and (2) to prohibit the admission by such facilities of persons with primary psychiatric diagnoses if such admission would jeopardize federal reimbursements.(1967, P.A. 759, S. 1(d); P.A. 75-420, S. 4, 6; P.A. 77-614, S. 608, 610; P.A. 87-113; P.A. 93-262, S. 1, 87.)History: P.A. 75-420 replaced welfare commissioner with commissioner of social services; P.A. 77-614 replaced commissioner of social services with commissioner of income maintenance, effective January 1, 1979; P.A. 87-113 added requirements for the regulations in Subdivs. (1) and (2); P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-134d transferred to Sec. 17b-262 in 1995.Annotations to former section 17-134d:Cited. 168 C. 336. Since disclaimer is invalid, state may reassess eligibility for assistance. 179 C. 463. Cited. 191 C. 384; 204 C. 17; 216 C. 85; 226 C. 818.Cited. 40 CS 394.Cited. 5 Conn. Cir. Ct. 567.Annotations to present section:Cited. 233 C. 557. Provision in Regs., Conn. State Agencies Sec. 17-134d-33(e)(1)(C) that entitles individual to nonemergency medical transportation to and from a medical provider only if services provided are “medical services covered by Medicaid” means services for which Medicaid program will actually pay, not services of a type covered by Medicaid; transportation costs that are eligible for Medicaid payment only if such medical services are provided in “a clinic or hospital setting” are not of same type as transportation costs for services provided by an independent psychologist in a private office setting, which are ineligible for Medicaid payment. 276 C. 618.
CT Gen Stat § 17b-263. (Formerly Sec. 17-274b) (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-263. (Formerly Sec. 17-274b) - Utilization of outpatient mental health services. Contracts for services. Fee schedule and payment for services.

 (a) The Commissioner of Social Services shall extend the provisions of section 17-134d-11 of the regulations of Connecticut state agencies to monitor and control Medicaid recipient utilization of outpatient mental health services. The commissioner shall contract, through a competitive bidding process, for recipient surveillance and review services. Such contract shall authorize the imposition of utilization controls, including but not limited to, prior authorization requirements based on medical appropriateness and cost effectiveness.(b) Notwithstanding the provisions of subsection (c) of section 17b-239, the commissioner shall establish a service-specific fee schedule for hospital outpatient mental health therapy services, except for partial hospitalization and other comprehensive services as defined by the commissioner. Payment for partial hospitalization services shall be considered payment in full for all outpatient mental health services.(June Sp. Sess. P.A. 91-8, S. 10, 63; P.A. 93-262, S. 1, 87; P.A. 11-233, S. 5; May Sp. Sess. P.A. 16-3, S. 88.)History: P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-274b transferred to Sec. 17b-263 in 1995; P.A. 11-233 amended Subsec. (b) by deleting provision re rate paid to be rate established in Sec. 17b-239(d) and adding provision requiring commissioner to establish service-specific fee schedule, effective July 1, 2011; May Sp. Sess. P.A. 16-3 amended Subsec. (b) by replacing reference to Sec. 17b-239(d) with reference to Sec. 17b-239(c), effective June 2, 2016.Cited. 233 C. 557.
CT Gen Stat § 17b-263a (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-263a - Amendment to state Medicaid plan to include assertive community treatment teams and community support services.

 Section 17b-263a is repealed, effective June 6, 2018.(P.A. 05-280, S. 84; P.A. 11-215, S. 9; P.A. 18-99, S. 2.)
CT Gen Stat § 17b-263b (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-263b - Pilot program for individuals ages nineteen to twenty-one with a mental disorder and chronic health condition. Eligibility.

 Section 17b-263b is repealed, effective July 1, 2011.(P.A. 05-280, S. 11; P.A. 11-44, S. 178.)
CT Gen Stat § 17b-264. (Formerly Sec. 17-134e) (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-264. (Formerly Sec. 17-134e) - Extension of other public assistance provisions.

 All of the provisions of sections 17b-22, 17b-75 to 17b-77, inclusive, 17b-79 to 17b-83, inclusive, 17b-85 to 17b-103, inclusive, and 17b-600 to 17b-604, inclusive, are extended to the medical assistance program except such provisions as are inconsistent with federal law and regulations governing Title XIX of the Social Security Amendments of 1965 and sections 17b-260 to 17b-262, inclusive, 17b-264 to 17b-285, inclusive, and 17b-357 to 17b-361, inclusive.(1967, P.A. 759, S. 1(e); June 18 Sp. Sess. P.A. 97-2, S. 71, 165; P.A. 05-280, S. 23; P.A. 06-188, S. 19.)History: Sec. 17-134e transferred to Sec. 17b-264 in 1995; June 18 Sp. Sess. P.A. 97-2 made technical changes, effective July 1, 1997; P.A. 05-280 substituted reference to Sec. 17b-361 for reference to repealed Sec. 17b-362, effective July 1, 2005; P.A. 06-188 replaced reference to “17b-79 to 17b-103, inclusive” with “17b-79 to 17b-83, inclusive, 17b-85 to 17b-103, inclusive” re statutory provisions that are extended to the medical assistance program, effective July 1, 2006.Annotations to former section 17-134e:Cited. 168 C. 336; 172 C. 292. Since disclaimer is invalid, state may reassess eligibility for assistance. 179 C. 463. Cited. 204 C. 17; 209 C. 390; 216 C. 85; 225 C. 314.Cited. 44 CA 143.Section extends the provisions of chapter 302 to the medical assistance program except such provisions which are inconsistent with federal law and part IV of chapter 302. 32 CS 523.Annotations to present section:Cited. 233 C. 557; 237 C. 550; 240 C. 141.Cited. 44 CA 143.
CT Gen Stat § 17b-265a (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-265a - Physicians providing services to dually eligible Medicaid and Medicare clients. Rates.

 Effective April 1, 2003, the Commissioner of Social Services shall, within available Medicaid appropriations, grant a rate increase to physicians who provide services to clients who are eligible under both Medicaid and Medicare.(May 9 Sp. Sess. P.A. 02-7, S. 54.)History: May 9 Sp. Sess. P.A. 02-7 effective August 15, 2002.See Sec. 17b-265 re insurance coverage of medical assistance recipients and limitations.
CT Gen Stat § 17b-265b (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-265b - Reimbursement rates for pathologists.

 (a) The Commissioner of Social Services shall reimburse pathologists, licensed pursuant to chapter 370, who provide medical services to individuals under programs administered by the department, for the professional component of their service, with no distinction made as to whether such service is provided in a hospital or outpatient setting. In no event shall such rate exceed the prevailing rate paid to physicians for similar physician services.(b) For the fiscal years ending June 30, 2004, and June 30, 2005, any increase in reimbursement shall not exceed the aggregate sum of one hundred fifty thousand dollars for each fiscal year.(June 30 Sp. Sess. P.A. 03-3, S. 79.)History: June 30 Sp. Sess. P.A. 03-3 effective August 20, 2003.
CT Gen Stat § 17b-265c (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-265c - Medicaid and Medicare dually eligible pilot program.

 The Commissioner of Social Services, to the extent permitted by federal law, shall amend the Medicaid state plan to establish a pilot program serving not more than five hundred elderly or disabled state medical assistance recipients who are also eligible for Medicare and who voluntarily opt to participate in the program. Such program shall demonstrate the feasibility and cost effectiveness of delivering comprehensive health insurance coverage in a managed care setting to such recipients. The commissioner may include medical assistance services in the pilot program not presently covered in the state medical assistance program or other modifications to the state medical assistance program to encourage voluntary participation in the pilot program.(P.A. 04-258, S. 4.)History: P.A. 04-258 effective June 1, 2004.
CT Gen Stat § 17b-265e (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-265e - Medicare Part D Supplemental Needs Fund. Payment by department for nonformulary prescription drugs. Rebates required for pharmaceutical manufacturers. Contracts for supplemental rebates.

 Section 17b-265e is repealed, effective July 1, 2011.(Nov. 2 Sp. Sess. P.A. 05-2, S. 2; P.A. 06-188, S. 13; June Sp. Sess. P.A. 07-2, S. 4; June Sp. Sess. P.A. 07-5, S. 26; P.A. 08-1, S. 2; P.A. 09-8, S. 6; 09-14, S. 2; P.A. 11-44, S. 178.)
CT Gen Stat § 17b-265f (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-265f - Payment by the department for pharmacy claims. Limitations. Investigation of pharmacy.

 No pharmacy shall claim payment from the Department of Social Services under a medical assistance program administered by the department for prescription drugs dispensed to individuals who have other prescription drug insurance coverage unless such coverage has been exhausted and the individual is otherwise eligible for such a medical assistance program. The department shall recoup from the submitting pharmacy any claims submitted to and paid by the department when other insurance coverage is available. The department shall investigate a pharmacy that consistently submits ineligible claims for payment to determine whether the pharmacy is in violation of its medical assistance provider agreement or is committing fraud or abuse in the program and based on the findings of such investigation, may take action against such pharmacy, in accordance with state and federal law.(June Sp. Sess. P.A. 07-2, S. 21; P.A. 11-44, S. 90.)History: June Sp. Sess. P.A. 07-2 effective June 26, 2007; P.A. 11-44 deleted reference to Medicare Part D Supplemental Needs Fund, effective July 1, 2011.
CT Gen Stat § 17b-265g (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-265g - Health insurer. Duties owed to the state and Commissioner of Social Services.

 Any health insurer, including a self-insured plan, group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plan, managed care organization, health care center, pharmacy benefit manager, dental benefit manager or other party that is, by statute, contract or agreement, legally responsible for payment of a claim for a health care item or service, and which may or may not be financially at risk for the cost of a health care item or service, shall, as a condition of doing business in the state, be required to: (1) Provide, with respect to an individual who is eligible for, or is provided, medical assistance under the Medicaid state plan, to all third-party administrators, pharmacy benefit managers, dental benefit managers or other entities with which the health insurer has a contract or arrangement to adjudicate claims for a health care item or service, and to the Commissioner of Social Services, or the commissioner's designee, any and all information in a manner and format prescribed by the commissioner, or commissioner's designee, necessary to determine when the individual, his or her spouse or the individual's dependents may be or have been covered by a health insurer and the nature of the coverage that is or was provided by such health insurer including the name, address and identifying number of the plan; (2) accept the state's right of recovery and the assignment to the state of any right of an individual or other entity to payment from the health insurer for an item or service for which payment has been made under the Medicaid state plan; (3) respond to any inquiry by the commissioner, or the commissioner's designee, regarding a claim for payment for any health care item or service that is submitted not later than three years after the date of the provision of the item or service; and (4) agree not to deny a claim submitted by the state solely on the basis of the date of submission of the claim, the type or format of the claim form or a failure to present proper documentation at the point-of-sale that is the basis of the claim, if (A) the claim is submitted by the state or its agent within the three-year period beginning on the date on which the item or service was furnished; and (B) any legal action by the state to enforce its rights with respect to such claim is commenced within six years of the state's submission of such claim.(June Sp. Sess. P.A. 07-2, S. 19.)History: June Sp. Sess. P.A. 07-2 effective July 1, 2007.
CT Gen Stat § 17b-266a (2020)
2020 Connecticut General Statutes|Title 17b - Social Services|Chapter 319v - Medical Assistance|Section 17b-266a - Contract with pharmacy benefits management organization.

 Section 17b-266a is repealed, effective July 1, 2010.(P.A. 04-258, S. 7; P.A. 10-179, S. 160.)