2023 Connecticut General Statutes › Title 17b - Social Services › Chapter 319v - Medical Assistance › Section 17b-290. - Definitions.

As used in this section and sections 17b-292, 17b-295, 17b-297a, 17b-297b and 17b-300:
(1) “Applicant” means an individual over the age of eighteen years who is a natural or adoptive parent, a legal guardian, a caretaker relative, foster parent or stepparent with whom the child resides and shall include a child who is eighteen years of age or emancipated in accordance with the provisions of sections 46b-150 to 46b-150e, inclusive, and who is applying on his own behalf or on behalf of a minor dependent for coverage under such plan;
(2) “Child” means an individual under nineteen years of age;
(3) “Coinsurance” means the sharing of health care expenses by the insured and an insurer in a specified ratio;
(4) “Commissioner” means the Commissioner of Social Services;
(5) “Copayment” means a payment made on behalf of a member for a specified service under HUSKY B;
(6) “Cost sharing” means arrangements made on behalf of a member whereby an applicant pays a portion of the cost of health services, sharing costs with the state and includes copayments, premiums, deductibles and coinsurance;
(7) “Deductible” means the amount of out-of-pocket expenses that would be paid for health services on behalf of a member before becoming payable by the insurer;
(8) “Department” means the Department of Social Services;
(9) “Durable medical equipment” means equipment that meets all of the following requirements:
(A) Can withstand repeated use;
(B) Is primarily and customarily used to serve a medical purpose;
(C) Generally is not useful to a person in the absence of an illness or injury; and
(D) Is nondisposable;
(10) “Eligible beneficiary” means a child who meets the requirements in section 17b-292, and the requirements specified in Section 2110(b)(2)(B) of the Social Security Act as amended by Section 10203(b)(2)(D) of the Affordable Care Act;
(11) “Household” has the same meaning as provided in 42 CFR 435.603;
(12) “Household income” has the same meaning as provided in 42 CFR 435.603;
(13) “HUSKY A” means Medicaid provided to children, caretaker relatives and pregnant and postpartum women pursuant to section 17b-261 or 17b-277;
(14) “HUSKY B” means the health coverage for children established pursuant to the provisions of sections 17b-290, 17b-292, 17b-295, 17b-297a, 17b-297b and 17b-300;
(15) “HUSKY C” means Medicaid provided to individuals who are sixty-five years of age or older or who are blind or have a disability;
(16) “HUSKY D” or “Medicaid Coverage for the Lowest Income Populations program” means Medicaid provided to nonpregnant low-income adults who are age eighteen to sixty-four, as authorized pursuant to section 17b-8a;
(17) “HUSKY Health” means the combined HUSKY A, HUSKY B, HUSKY C and HUSKY D programs, that provide medical coverage to eligible children, parents, relative caregivers, persons age sixty-five or older, individuals with disabilities, low-income adults, and pregnant women;
(18) “Member” means an eligible beneficiary who receives services under HUSKY A, B, C or D;
(19) “Parent” means a natural parent, stepparent, adoptive parent, guardian or custodian of a child;
(20) “Premium” means any required payment made by an individual to offset the cost under HUSKY B;
(21) “Qualified entity” means any entity: (A) Eligible for payments under a state plan approved under Medicaid and which provides medical services under HUSKY A, or (B) that is a qualified entity, as defined in 42 USC 1396r-1a, as amended by Section 708 of Public Law 106-554, and that is determined by the commissioner to be capable of making the determination of eligibility. The commissioner shall provide qualified entities with such forms or information on filing an application electronically as is necessary for an application to be made on behalf of a child under HUSKY A and information on how to assist parents, guardians and other persons in completing and filing such forms or electronic application;
(22) “WIC” means the federal Special Supplemental Food Program for Women, Infants and Children administered by the Department of Public Health pursuant to section 19a-59c.
(Oct. 29 Sp. Sess. P.A. 97-1, S. 2, 23; P.A. 99-279, S. 18, 45; P.A. 00-196, S. 53; P.A. 01-137, S. 2, 9; June 30 Sp. Sess. P.A. 03-3, S. 73; P.A. 05-44, S. 2; P.A. 10-179, S. 61; June Sp. Sess. P.A. 10-1, S. 32; P.A. 11-25, S. 11; P.A. 15-69, S. 20; June Sp. Sess. P.A. 15-5, S. 373; P.A. 21-123, S. 3.)
History: Oct. 29 Sp. Sess. P.A. 97-1 effective October 30, 1997; P.A. 99-279 amended Subdiv. (10) to provide that a child of a municipal employee may be eligible for coverage under the HUSKY Plan, Part B if dependent coverage was terminated due to an extreme economic hardship on the part of the employee, as determined by the commissioner, effective July 1, 1999; P.A. 00-196 made technical changes in Subdivs. (21) and (22); P.A. 01-137 amended Subdiv. (22) to redefine “qualified entity” by deleting language contained in the federal definition of term and adding reference to such federal definition, effective July 1, 2001 (Revisor's note: In Subdiv. (22), the word “that” was inserted editorially by the Revisors after “(B)” for proper form); June 30 Sp. Sess. P.A. 03-3 amended introductory language to add reference to Sec. 17b-261f, effective August 20, 2003; P.A. 05-44 amended Subdiv. (13) to redefine “HUSKY Plan, Part A” to include assistance provided to caretaker relatives and pregnant women pursuant to Sec. 17b-261 or 17b-277, effective July 1, 2005 (Revisor's note: An erroneous reference to Sec. 17b-261f was deleted editorially by the Revisors to correct a codification error); P.A. 10-179 amended Subdiv. (11) by deleting reference to managed care plan, deleted former Subdiv. (15) defining “HUSKY Plus programs”, redesignated existing Subdiv. (16) as Subdiv. (15), deleted former Subdiv. (17) defining “managed care plan”, redesignated existing Subdivs. (18) to (23) as Subdivs. (16) to (21) and amended redesignated Subdiv. (17) by replacing “capitation rate” with “cost”, effective July 1, 2010; June Sp. Sess. P.A. 10-1 added new Subdiv. (15) defining “HUSKY Plus programs” and redesignated existing Subdivs. (15) to (21) as Subdivs. (16) to (22), effective July 1, 2010; P.A. 11-25 made a technical change in Subdiv. (21); P.A. 15-69 replaced references to Secs. 17b-289 to 17b-303 and Sec. 16 of Oct. 29 Sp. Sess. P.A. 97-1 with references to section and Secs. 17b-292, 17b-294a, 17b-295, 17b-297a, 17b-297b and 17b-300, redefined “applicant”, “copayment”, “cost sharing”, “deductible”, “durable medical equipment” and “eligible beneficiary”, deleted definitions of “enrollee”, “family”, “income”, “preventive care and services” and “primary and preventive health care services”, added definitions of “household”, “household income”, “HUSKY C”, “HUSKY D” or “Medicaid Coverage for the Lowest Income Populations program” and “HUSKY Health”, replaced defined terms of “HUSKY Plan, Part A”, “HUSKY Plan, Part B” and “HUSKY Plus programs” with “HUSKY A”, “HUSKY B” and “HUSKY Plus”, respectively, and made conforming changes, effective June 19, 2015; June Sp. Sess. P.A. 15-5 made technical changes in Subdiv. (1) and deleted “or pay in full” in Subdiv. (21), effective August 1, 2015; P.A. 21-123 deleted references to section 17b-294a in introductory language and Subdiv. (14), deleted Subdiv. (18) re the HUSKY Plus program and redesignated existing Subdivs. (19) to (23) as Subdivs. (18) to (22), effective July 6, 2021.