reglab/statecodes huggingface dataset:
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 31z - Bond Fund Grants to Establish Child Care Facilities for Children of Municipal and State Employees › Section 17-31z-13 - Application review and processing

Current through July 10, 2024
The application shall include the following information:
The Department's process for application review to the
				execution stage is as follows:
(a) The
			 Department reviews the application. The primary responsibility for all
			 information forwarded to the Department rests with the applicant and his
			 architect.
(b) After all questions
			 have been resolved a recommendation is forwarded to the Secretary of the State
			 Bond Commission requesting that the applicant's request for funding be placed
			 on its agenda for review and decision.
(c) Upon approval by the State Bond
			 Commission, the applicant may forward the grant action to the Commissioner for
			 his approval.
(d) The applicant
			 shall notify the Department of the scheduled date for the bid openings. After
			 the bid opening, the applicant shall submit to the Department:
(1) Affidavit of publication, or copy of bid
			 advertisement;
(2) A copy of each
			 bid;
(3) A copy of all bid bonds or
			 certified checks, if required; and
(4) Any other documents required by the
			 Department.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 31z - Bond Fund Grants to Establish Child Care Facilities for Children of Municipal and State Employees › Section 17-31z-14 - Execution of project

Current through July 10, 2024
(a) The Department
			 shall be notified of the date and time of the construction contract signing.
			 After the contract signing, the applicant shall submit to the Department:
(1) One copy of the Executed
			 Contract;
(2) One copy of each:
			 Performance Bond; Labor and Material Payment Bond and Power of Attorney for
			 Surety.
(3) One copy of
			 contractor's certificate of Insurance.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 31z - Bond Fund Grants to Establish Child Care Facilities for Children of Municipal and State Employees › Section 17-31z-15 - Project financing

Current through July 10, 2024
(a) The applicant
			 shall submit financial reports in duplicate on Department forms with payment
			 requests and upon completion of the program.
(b) Financial records shall be maintained in
			 accordance with the Department's Manual for Grantee Accounting, and shall
			 provide a basis together with the financial reports, for a final independent
			 audit.
(c) Upon completion a final
			 inspection will be made by department staff.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 32 - Fair Hearings › Section 17-32-1 to 17-32-13 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-32-1
17a-90-1
17-32-2
17a-90-2
17-32-3
17a-90-3
17-32-4
17a-90-4
17-32-5
17a-90-5
17-32-6
17a-90-6
17-32-7
17a-90-7
17-32-8
17a-90-8
17-32-9
17a-90-9
17-32-10
17a-90-10
17-32-11
17a-90-11
17-32-12
17a-90-12
17-32-13
17a-90-13
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 32(b) - Non-Committed Treatment Program › Section 17-32(b)-1 to 17-32(b)-10 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-32 (b)-1
17a-90 (b)-1
17-32 (b)-2
17a-90 (b)-2
17-32 (b)-3
17a-90 (b)-3
17-32 (b)-4
17a-90 (b)-4
17-32 (b)-5
17a-90 (b)-5
17-32 (b)-6
17a-90 (b)-6
17-32 (b)-7
17a-90 (b)-7
17-32 (b)-8
17a-90 (b)-8
17-32 (b)-9
17a-90 (b)-9
17-32 (b)-10
17a-90 (b)-10
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 37 - Removal Hearings-Removal of a Child From a Foster Home › Section 17-37-1 to 17-37-9 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-37-1
17a-98-1
17-37-2
17a-98-2
17-37-3
17a-98-3
17-37-4
17a-98-4
17-37-5
17a-98-5
17-37-6
17a-98-6
17-37-7
17a-98-7
17-37-8
17a-98-8
17-37-9
17a-98-9
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 38a - Use and Operation of the Child Abuse and Neglect Registry › Section 17-38a-1 to 17-38a-10 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-38a-1
17a-101-1
17-38a-2
17a-101-2
17-38a-3
17a-101-3
17-38a-4
17a-101-4
17-38a-5
17a-101-5
17-38a-6
17a-101-6
17-38a-7
17a-101-7
17-38a-8
17a-101-8
17-38a-9
17a-101-9
17-38a-10
17a-101-10
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 38a - Use and Operation of the Child Abuse and Neglect Registry › Circumstances Requiring Immediate Removal of a Child from his/her Home 96-Hour Hold › Section 17-38a-11 to 17-38a-13 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
							 Number
New Number
17-38a-11
17a-101-11
17-38a-12
17a-101-12
17-38a-13
17a-101-13
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 38a(e) - Reports of Child Abuse or Neglect › Section 17-38a(e)-1 to 17-38a(e)-6 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-38a (e)-1
17a-101 (e)-1
17-38a (e)-2
17a-101 (e)-2
17-38a (e)-3
17a-101 (e)-3
17-38a (e)-4
17a-101 (e)-4
17-38a (e)-5
17a-101 (e)-5
17-38a (e)-6
17a-101 (e)-6
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 43c - Relative Licensing › Section 17-43c-1 to 17-43c-13 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-43c-1
17a-114-1
17-43c-2
17a-114-2
17-43c-3
17a-114-3
17-43c-4
17a-114-4
17-43c-5
17a-114-5
17-43c-6
17a-114-6
17-43c-7
17a-114-7
17-43c-8
17a-114-8
17-43c-9
17a-114-9
17-43c-10
17a-114-10
17-43c-11
17a-114-11
17-43c-12
17a-114-12
17-43c-13
17a-114-13
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 44a - Subsidized Adoptions of Hard-to-Place Children › Subsidized Adoption of Special Needs Children › Section 17-44a-6 to 17-44a-14 - Transferred

Current through July 10, 2024
Transferred, March 26, 1994.
Former
							 Number
New Number
17-44a-6
17a-116-6
17-44a-7
17a-116-7
17-44a-8
17a-116-8
17-44a-9
17a-116-9
17-44a-10
17a-116-10
17-44a-11
17a-116-11
17-44a-12
17a-116-12
17-44a-13
17a-116-13
17-44a-14
17a-116-14
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 44e - Medical Expense Subsidy for Adoptive Parents of a Physically Handicapped Child › Medical Expense Subsidy for Adoptive Parents › Section 17-44e-3 to 17-44e-9 - Transferred

Current through July 10, 2024
Transferred, March 26, 1994.
Former
							 Number
New Number
17-44e-3
17a-120-3
17-44e-4
17a-120-4
17-44e-5
17a-120-5
17-44e-6
17a-120-6
17-44e-7
17a-120-7
17-44e-8
17a-120-8
17-44e-9
17a-120-9
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 48 - Operation of Child-Caring Agencies and Facilities › Section 17-48-48 to 17-48-129 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-48-48
17a-145-48
17-48-49
17a-145-49
17-48-50
17a-145-50
17-48-51
17a-145-51
17-48-52
17a-145-52
17-48-53
17a-145-53
17-48-54
17a-145-54
17-48-55
17a-145-55
17-48-56
17a-145-56
17-48-57
17a-145-57
17-48-58
17a-145-58
17-48-59
17a-145-59
17-48-60
17a-145-60
17-48-61
17a-145-61
17-48-62
17a-145-62
17-48-63
17a-145-63
17-48-64
17a-145-64
17-48-65
17a-145-65
17-48-66
17a-145-66
17-48-67
17a-145-67
17-48-68
17a-145-68
17-48-69
17a-145-69
17-48-70
17a-145-70
17-48-71
17a-145-71
17-48-72
17a-145-72
17-48-73
17a-145-73
17-48-74
17a-145-74
17-48-75
17a-145-75
17-48-76
17a-145-76
17-48-77
17a-145-77
17-48-78
17a-145-78
17-48-79
17a-145-79
17-48-80
17a-145-80
17-48-81
17a-145-81
17-48-82
17a-145-82
17-48-83
17a-145-83
17-48-84
17a-145-84
17-48-85
17a-145-85
17-48-86
17a-145-86
17-48-87
17a-145-87
17-48-88
17a-145-88
17-48-89
17a-145-89
17-48-90
17a-145-90
17-48-91
17a-145-91
17-48-92
17a-145-92
17-48-93
17a-145-93
17-48-94
17a-145-94
17-48-95
17a-145-95
17-48-96
17a-145-96
17-48-97
17a-145-97
17-48-98
17a-145-98
17-48-99
17a-145-99
17-48-100
17a-145-100
17-48-101
17a-145-101
17-48-102
17a-145-102
17-48-103
17a-145-103
17-48-104
17a-145-104
17-48-105
17a-145-105
17-48-106
17a-145-106
17-48-107
17a-145-107
17-48-108
17a-145-108
17-48-109
17a-145-109
17-48-110
17a-145-110
17-48-111
17a-145-111
17-48-112
17a-145-112
17-48-113
17a-145-113
17-48-114
17a-145-114
17-48-115
17a-145-115
17-48-116
17a-145-116
17-48-117
17a-145-117
17-48-118
17a-145-118
17-48-119
17a-145-119
17-48-120
17a-145-120
17-48-121
17a-145-121
17-48-122
17a-145-122
17-48-123
17a-145-123
17-48-124
17a-145-124
17-48-125
17a-145-125
17-48-126
17a-145-126
17-48-127
17a-145-127
17-48-128
17a-145-128
17-48-129
17a-145-129
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 49b - Operation of Child Placing Agencies Child Placing Agencies › Section 17-49b-1 to 17-49b-50 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-49b-1
17a-150-1
17-49b-2
17a-150-2
17-49b-3
17a-150-3
17-49b-4
17a-150-4
17-49b-5
17a-150-5
17-49b-6
17a-150-6
17-49b-7
17a-150-7
17-49b-8
17a-150-8
17-49b-9
17a-150-9
17-49b-10
17a-150-10
17-49b-11
17a-150-11
17-49b-12
17a-150-12
17-49b-13
17a-150-13
17-49b-14
17a-150-14
17-49b-15
17a-150-15
17-49b-16
17a-150-16
17-49b-17
17a-150-17
17-49b-18
17a-150-18
17-49b-19
17a-150-19
17-49b-20
17a-150-20
17-49b-21
17a-150-21
17-49b-22
17a-150-22
17-49b-23
17a-150-23
17-49b-24
17a-150-24
17-49b-25
17a-150-25
17-49b-26
17a-150-26
17-49b-27
17a-150-27
17-49b-28
17a-150-28
17-49b-29
17a-150-29
17-49b-30
17a-150-30
17-49b-31
17a-150-31
17-49b-32
17a-150-32
17-49b-33
17a-150-33
17-49b-34
17a-150-34
17-49b-35
17a-150-35
17-49b-36
17a-150-36
17-49b-37
17a-150-37
17-49b-38
17a-150-38
17-49b-39
17a-150-39
17-49b-40
17a-150-40
17-49b-41
17a-150-41
17-49b-42
17a-150-42
17-49b-43
17a-150-43
17-49b-44
17a-150-44
17-49b-45
17a-150-45
17-49b-46
17a-150-46
17-49b-47
17a-150-47
17-49b-48
17a-150-48
17-49b-49
17a-150-49
17-49b-50
17a-150-50
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 52b - Licensing of Permanent Family Residences › Section 17-52b-1 to 17-52b-35 - Transferred

Current through July 10, 2024
Transferred, February 1, 1994.
Former
						  Number
New Number
17-52b-1
17a-155-1
17-52b-2
17a-155-2
17-52b-3
17a-155-3
17-52b-4
17a-155-4
17-52b-5
17a-155-5
17-52b-6
17a-155-6
17-52b-7
17a-155-7
17-52b-8
17a-155-8
17-52b-9
17a-155-9
17-52b-10
17a-155-10
17-52b-11
17a-155-11
17-52b-12
17a-155-12
17-52b-13
17a-155-13
17-52b-14
17a-155-14
17-52b-15
17a-155-15
17-52b-16
17a-155-16
17-52b-17
17a-155-17
17-52b-18
17a-155-18
17-52b-19
17a-155-19
17-52b-20
17a-155-20
17-52b-21
17a-155-21
17-52b-22
17a-155-22
17-52b-23
17a-155-23
17-52b-24
17a-155-24
17-52b-25
17a-155-25
17-52b-26
17a-155-26
17-52b-27
17a-155-27
17-52b-28
17a-155-28
17-52b-29
17a-155-29
17-52b-30
17a-155-30
17-52b-31
17a-155-31
17-52b-32
17a-155-32
17-52b-33
17a-155-33
17-52b-34
17a-155-34
17-52b-35
17a-155-35
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 83k - Administrative Sanctions to be Invoked Against Vendors and/or Providers of Goods and Services Under the Title XIX (Medicaid) Program › Section 17-83k-2 - Failure to meet or to continue to meet eligibility criteria

Current through July 10, 2024
Vendors must meet and maintain eligibility criteria of program
				participation specified in Federal and State Statutes and Regulations and in
				departmental contracts or agreements. Failure to meet criteria for eligibility
				will result in the suspension of a vendor's participation.
Whenever the Department of Income Maintenance (hereinafter
				referred to as "Department") receives notification from the Licensing or
				Certifying Agency that a participating vendor has received either notice of
				denial of certification when such certification is required by Federal or State
				Statute or regulation, or has received notice of a denial of federal financial
				participation, or of an application for renewal of a license, certificate,
				permit or the like, when such license, certificate, permit or the like
				represents a prerequisite for participation, the Commissioner may suspend such
				vendor from further participation in the program.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 83k - Administrative Sanctions to be Invoked Against Vendors and/or Providers of Goods and Services Under the Title XIX (Medicaid) Program › Section 17-83k-3 - Violations of rules, regulations, standards and laws

Current through July 10, 2024
All vendors are subject to the federal and state laws and rules
				and regulations governing the programs in which they participate. Following are
				examples of violations by vendors of these laws, rules or regulations which
				constitute good cause for the imposition of administrative sanctions against
				such vendors:
(1) Accepting payment
			 for goods provided to and/or services performed for any beneficiary under
			 Chapter 302 of the Connecticut General Statutes, which payment exceeds the
			 amount(s) due or authorized by law for such goods and/or services.
(2) Soliciting to perform services for and/or
			 sell goods to any such beneficiary or recipient knowing that such beneficiary
			 or recipient is not in need of such goods or services.
(3) Selling goods to or performing services
			 for any such beneficiary or recipient without prior authorization by the
			 Department of Income Maintenance when prior authorization is required by said
			 Department for the buying of such goods or the performance of any such
			 service.
(4) Accepting from any
			 person or source other than the State an additional compensation in excess of
			 the amount authorized by law for goods provided to or services performed for
			 any such beneficiary or recipient.
(5) Knowingly and willfully making, or
			 causing to be made, any false statement or misrepresentation of material fact
			 for the purpose of claiming or determining payment.
(6) Furnishing or ordering services that are
			 in excess of the recipient's needs or that fail to meet professionally
			 recognized standards.
(7)
			 Submitting or causing to be submitted to the program bills or requests for
			 payment containing charges or costs that are in excess of customary charges or
			 costs.
(8) Any of the fraudulent
			 acts and/or false reporting proscribed under federal or state
			 statutes.
(9) Failure of a vendor
			 to comply with any provision of a contract or agreement which is in effect
			 between said vendor and the Department of Income Maintenance.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 83k - Administrative Sanctions to be Invoked Against Vendors and/or Providers of Goods and Services Under the Title XIX (Medicaid) Program › Section 17-83k-4a - Sanction procedures for non-convicted vendors

Current through July 10, 2024
If the Department has reason to believe that a vendor has
				committed a violation, which violation has not resulted in a criminal
				conviction, the Commissioner may impose one or more of the administrative
				sanctions outlined in Sec.
				17-83k-5 of
				these Regulations, in accordance with the following procedures:
(a)
Written notice.
Before
			 imposing a sanction, the Commissioner shall send by certified mail, return
			 receipt requested, written notice to the vendor, which notice shall include:
(1) A statement of the alleged violation or
			 violations,
(2) Notice of the right
			 to a hearing,
(3) A statement that
			 proof of said violations may result in the imposition of sanctions,
(4) A copy of this regulation.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 83k - Administrative Sanctions to be Invoked Against Vendors and/or Providers of Goods and Services Under the Title XIX (Medicaid) Program › Section 17-83k-5 - Sanctions

Current through July 10, 2024
(a) Sanctions shall include, but shall not be
			 limited to any one or more of the following:
(1) An order to make restitution, with
			 interest at the rate provided by statute, as a condition of continued
			 participation.
(2) Suspension from
			 participation.
(3) Limitation on a
			 provider's participation.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 83k - Administrative Sanctions to be Invoked Against Vendors and/or Providers of Goods and Services Under the Title XIX (Medicaid) Program › Section 17-83k-6 - Termination upon conviction

Current through July 10, 2024
(a) Notwithstanding
			 any other provisions of these regulations to the contrary, any vendor against
			 whom a judgment of conviction has been rendered in any state or federal court
			 of a crime involving fraud in said programs shall be terminated from
			 participation. Termination shall be effective upon conviction, except that the
			 Commissioner may delay termination for a period he deems sufficient to protect
			 the health and well-being of beneficiaries receiving goods and/or services from
			 such vendor. No vendor or person so terminated or denied reimbursement shall be
			 readmitted to or be eligible for reimbursement in such programs for at least
			 one year from the date of termination or conviction.
(b) The Commissioner shall notify said vendor
			 of such termination by certified mail, return receipt requested. The
			 notification shall inform the vendor of his/her ineligibility for reimbursement
			 for any goods provided or services performed directly by, or under the
			 supervision of, said vendor for the period of termination, and of the right to
			 a hearing, provided the request is filed with the Commissioner in writing
			 within ten (10) days of the notice date.
(c) The scope of the hearing shall be limited
			 to (1) whether the vendor was convicted, (2) whether the conviction is related
			 to the vendor's participation in programs conducted by the Department of Income
			 Maintenance, (3) whether the amount of restitution sought by the Department is
			 accurate, and (4) the appropriateness of the period of termination.
(d) In setting the termination period, the
			 Department will consider:
(1) The number and
			 nature of the program violations and other related offenses;
(2) The nature and extent of any adverse
			 impact the violations have had on beneficiaries;
(3) The amount of damages incurred by
			 Medicaid, or other social service programs for which the Department is
			 responsible;
(4) Whether there are
			 any mitigating circumstances;
(5)
			 The length of the sentence imposed by the court;
(6) Any other facts bearing on the nature and
			 seriousness of the program violations, and
(7) The previous sanction record of the
			 terminated party.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 83k - Administrative Sanctions to be Invoked Against Vendors and/or Providers of Goods and Services Under the Title XIX (Medicaid) Program › Section 17-83k-7 - Reinstatement

Current through July 10, 2024
(a)
After suspension.
Upon
			 completion of all obligations imposed by sanction or 30 days prior to the
			 expiration of the suspension period, whichever is later, the vendor may submit
			 to the Commissioner a request for reinstatement. Approval of said request, if
			 granted, shall be sent the vendor, and all who were informed of the sanction,
			 in writing. In deciding whether to approve such request the Commissioner may
			 consider the nature and degree of the offense leading to the sanction, the
			 likelihood of its recurrence, and any other factors the Commissioner deems
			 appropriate. The burden of proof shall be upon the vendor.
(b)
After termination.
Upon
			 expiration of the period of termination the vendor may request reinstatement by
			 making written request to the Commissioner for a hearing in accordance with
			 Sections
			 4-177
			 to
			 4-180
			 of the Uniform Administrative Procedure Act. At said hearing the burden of
			 proof shall be on the vendor seeking reinstatement.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 109a - Safeguarding Resident's Personal Funds Handled by Licensed Homes for the Aged › Section 17-109a-1 - Definitions

Current through July 10, 2024
For the purposes of Regulations Section
				17-109a-2,
				the following definitions apply:
(a)
			 "Home" shall mean a licensed home for the aged, and the person or persons
			 authorized by the home to handle residents' personal funds.
(b) "Resident" shall mean a resident of such
			 home who is a recipient of the State Supplement for the Aged, Blind or Disabled
			 program.
(c) "Department" shall
			 mean the Department of Income Maintenance.
(d) "Legally Liable Relative" shall mean the
			 husband or wife of any resident, as defined above, of a licensed home for the
			 aged, and the father and mother of any resident under the age of eighteen
			 years.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 109a - Safeguarding Resident's Personal Funds Handled by Licensed Homes for the Aged › Section 17-109a-2 - Safeguarding of residents' personal funds

Current through July 10, 2024
(a)
Purpose
This regulation provides safeguards for residents' personal
				funds which are handled by licensed homes for the aged.
(b)
Cashing Checks
When a home cashes a resident's check and funds are returned to
				the resident, the home shall require the resident to sign a receipt showing the
				date and the amount received.
(c)
Resident's Authorization
(1) When a home assumes responsibility for a
			 resident's funds, there shall be a statement on file signed by the resident
			 authorizing the home to handle the personal funds.
(2) If the resident has been determined by a
			 physician to be mentally incapable of understanding the terms of the
			 authorizing statement, the statement shall be signed by a conservator, guardian
			 or legally liable relative.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Section 17-134d-2 - Medical and remedial care and services (Repealed)

Current through July 10, 2024
For 2014 repeal, see
				  Sec.
				  54 of
				  Public
				  Act 14-187. (June 11,
				  2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Services for Functionally Disabled Clients Who Have No Vocational Objective › Section 17-134d-7 - Definitions as used in these regulations (Repealed)

Current through July 10, 2024
For 2014 repeal, see
					 Sec.
					 54 of
					 Public
					 Act 14-187. (June 11,
					 2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Services for Functionally Disabled Clients Who Have No Vocational Objective › Section 17-134d-8 - General provisions of services for functionally disabled clients who have no vocational objective (Repealed)

Current through July 10, 2024
For 2014 repeal, see
					 Sec.
					 54 of
					 Public
					 Act 14-187. (June 11,
					 2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Routine Medical Visits for Title XIX Recipients Residing in Homes for the Aged › Section 17-134d-10 - Reimbursement for routine medical visits for title XIX recipients residing in homes for the aged (Repealed)

Current through July 10, 2024
For 2014 repeal, see
					 Sec.
					 54 of
					 Public
					 Act 14-187. (June 11,
					 2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Routine Medical Visits for Title XIX Recipients Residing in Homes for the Aged › Section 17-134d-11 - Medicaid recipient surveillance and utilization review program (Repealed)

Current through July 10, 2024
For 2014 repeal, see
					 Sec.
					 54 of
					 Public
					 Act 14-187. (June 11,
					 2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Acute Care General Hospital Inpatient Weekend Admissions and Discharges under Title XIX (Medicaid) › Section 17-134d-20 - Acute care general hospital inpatient weekend admissions and discharges under title XIX (Medicaid) (Repealed)

Current through July 10, 2024
For 2014 repeal, see
					 Sec.
					 54 of
					 Public
					 Act 14-187. (June 11,
					 2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Immediate Medical Coverage for Newborn Children › Appendix A

Current through July 10, 2024
The following are the diagnoses codes which would be
				  acceptable justification for invalid coach transportation. Invalid coach trips
				  with these diagnoses do not require prior authorization.
170.2
Malignant neoplasm of bone, vertical
							 column
170.6
Malignant neoplasm of bone, pelvic bones, sacrum, and
							 coccyx
170.7
Malignant neoplasm of bone, long bones of lower
							 limb
170.8
Malignant neoplasm of bone, short bones of lower
							 limb
333.4
Huntington's chorea
334.0
Friedreich's Ataxia
342
Hemiplegia
344.0
Quadriplegia
344.1
Paraplegia
357.2
Diabetic Neuropathy
444.22
Thrombosis-lower extremity
820
Fx neck femur (within six (6) months)
822
Fx patella (within six (6) months)
823
Fx tibia and fibula (within six (6)
							 months)
896
Below knee amputation
897
Above knee amputation
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Immediate Medical Coverage for Newborn Children › Appendix B

Current through July 10, 2024
The following are conditions which would be acceptable
				  justification for non-emergency ambulance. Non-emergency ambulance trips for
				  clients with these conditions or needing these services do not require prior
				  authorization.
Casts Which Prevent Hip Flexion
Four Point Restraints
Comatose
Intravenous Running
Suctioning During Transport
Isolette
Prone Positioning (e.g. due to decubiti or skin
				  flaps)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Orthodontic Services Provided Under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program › Section 17-134d-35 - Orthodontic services provided under the early and periodic screening, diagnosis and treatment (EPSDT) program

Current through July 10, 2024
(a)
Orthodontic services will be paid for when
(1) provided by a qualified dentist;
				and
(2) deemed medically necessary
				as described in these regulations.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Coverage of Occupational Therapy Services by Home Health Agencies › Section 17-134d-39 - Reimbursement plan for medical transportation under the medical assistance program

Current through July 10, 2024
(a) Medical
				Transportation Services provided under the Medical Assistance Program will be
				purchased through a Volume Purchase Plan (V.P.P.), if this method will be more
				cost efficient than the present method of reimbursement, which is based on a
				fee schedule and metered rate for taxi.
(b) Under the V.P.P. the Department will
				contract with a provider(s) who will provide one or more of the designated
				types of transportation. Such providers must meet state licensure requirements,
				certification and registration requirements, current Departmental Medical
				Assistance requirements and provide the most cost efficient medical
				transportation service available.
(c) The V.P.P. will be implemented through a
				competitive bidding process. The Department will define geographical areas,
				populations to be served and the type of transportation needed by the
				identified populations. These elements will be identified by the Department for
				purposes of the competitive bidding process.
(d) In order to assure that competitive
				bidding will result in cost savings to the State, the geographical area covered
				by the proposed bid must account for a minimum of ten percent (10%) of total
				expenditures for that particular type of transportation, and the estimated
				savings to the State resulting from the proposed bid must be at least 10
				percent (10%) of the total expenditures for that particular type of
				transportation in that geographical area, or the Department will not award a
				contract.
(e) The contract will be
				awarded to the lowest responsible bidder(s), with the Department reserving the
				right to reject all or any bid and not award a contract to any of the bidders,
				if this best serves the interests of the State. The Department also reserves
				the right to award a contract for one, some, or all of the different types of
				medical transportation provided under the Medical Assistance Program.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Coverage of Occupational Therapy Services by Home Health Agencies › Section 17-134d-40 - Acute care hospital outpatient clinic reimbursement rate Hospital Outpatient Clinic Visit Rates (Repealed)

Current through July 10, 2024
For 2014 repeal, see
					 Sec.
					 54 of
					 Public
					 Act 14-187. (June 11,
					 2014)
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Long Term Care Facility Preadmission Screening and Community Based Services Program › Section 17-134d-43 - Medicaid requirements for organ transplantation

Current through July 10, 2024
(a) Organ
				transplantations are covered under the Medicaid program if they are of
				demonstrated therapeutic value, medically necessary and medically appropriate,
				and likely to result in the prolongation and the improvement in the quality of
				life of the applicant.
(b) The
				following organ transplantations have been deemed to satisfy the criteria of
				subsection (a) of section 17-134d-43, in all cases, and the costs associated
				with such procedures will be covered under Medicaid without the necessity of
				the patient obtaining prior authorization from the Department:
(1) bone;
(2) bone marrow;
(3) kidney;
(4) cornea.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Long Term Care Facility Preadmission Screening and Community Based Services Program › Section 17-134d-50 - Medicaid reimbursement clinical diagnostic laboratory services furnished by acute care hospitals

Current through July 10, 2024
(a)
Definitions
(1) This regulation
				defines the method of reimbursement of clinical diagnostic laboratory services
				provided by acute care hospitals to Connecticut Medical Assistance
				recipients.
(2) For the purposes of
				this regulation, "Clinical Diagnostic Laboratory Services" means those clinical
				diagnostic laboratory tests and related specimen collections subject to the
				statewide Clinical Diagnostic Laboratory Test Fee Schedule established by the
				State Medicare carrier for outpatient hospital-based laboratories effective
				July 1, 1984 in accordance with Section 2303 of Public Law 98-369. The
				procedures covered by this definition shall include or exclude any subsequent
				additions or deletions made by the State Medicare carrier for outpatient
				hospital-based laboratories. Each test covered is identified and described
				using the Health Care Financing Administration Common Procedures Coding System
				(HCPCS) five (5) digit procedure code and terminology or local codes and
				descriptions assigned by the State Medicare carrier.
(3) "Hospital Outpatient" means a person who
				has not been admitted by the hospital as an inpatient but is registered on the
				hospital records as an outpatient and is directly receiving outpatient hospital
				services (rather than supplies alone). Where the hospital uses the category
				"day patient," i.e., a person who directly receives hospital services during
				the day and is not expected to be lodged in the hospital at midnight, the
				individual is classified as an outpatient.
(4) "Hospital Nonpatient" means a person who
				is not registered on the hospital records as an outpatient or is not directly
				receiving services from the hospital but the hospital provides all or part of
				the required testing.
(5) For the
				purposes of these regulations, "hospital" means acute care Connecticut-based or
				border hospital.
(6) "Department"
				means the Department of Income Maintenance.
(7) "Rate Year" means beginning January 1,
				1987 the Medicaid rate year shall be concurrent with the Medicare rate
				year.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Long Term Care Facility Preadmission Screening and Community Based Services Program › Section 17-134d-68 - Requirements for monitoring psychiatric admissions to nursing homes

Current through July 10, 2024
(a)
Scope
(1) Medicaid is a program of "cooperative
				federalism" wherein federal financial participation is available for a
				percentage of the cost of medical assistance provided by a state under its
				Medicaid program. Under federal requirements, however, federal financial
				participation is not available for the cost of nursing facility services that
				are provided by facilities that are also considered to be institutions for
				mental diseases (IMDs) except for patients aged 65 and older. The purpose of
				these regulations is to establish requirements designed to prevent nursing
				homes which participate in the Medicaid program from being characterized as
				IMDs unless the IMD serves only patients aged 65 and older or unless the IMD is
				prepared to accept payment from some source other than Medicaid for all
				patients under 65 years of age. Specific remedies available to the Department
				under these regulations include the denial of authorization for the admission
				of psychiatric patients, the termination of Medicaid provider agreements, and
				the imposition of fiscal sanctions equal in amount to the loss of federal
				financial participation attributable to the facility's characterization as an
				IMD.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Title XIX Rates for Community Health Centers › Section 17-134d-79 - Requirements for the reservation of beds in nursing homes

Current through July 10, 2024
(a)
Definitions
(1) The definitions
				contained in Section
				19a-537
				of the Connecticut General Statutes apply to this subsection and subsections
				(b), (c) and (d) of this section; and
(2) "Level of Care" is further clarified, for
				purposes of this section, to refer to the level of care for which the nursing
				home is licensed, i.e., a chronic and convalescent nursing home or a rest home
				with nursing supervision. A change in level of care would occur only when the
				patient, upon return from the hospital, requires care consistent with these
				licensing standards which is different from his/her care requirements just
				prior to the time of admission to the hospital. This determination of change in
				level of care also applies when a patient is required to change from one
				licensed level to another within a facility which is licensed to provide both
				chronic and convalescent nursing home care and rest home with nursing
				supervision care.
(3) "Objective
				information," for purposes of this section, means an estimate of the patient's
				projected length of hospital stay obtained by the nursing home from a hospital
				staff person. This prognosis may be obtained from the patient record or the
				plan of care or given by a physician or other health professional under his
				direction or by another qualified professional such as a social worker or
				discharge planner.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Title XIX Rates for Community Health Centers › Section 17-134d-84 - Policy and procedures governing the need for service for oxygen therapy on behalf of Title XIX medicaid recipients

Current through July 10, 2024
(a)
Need for
				Services
The Department will pay for oxygen therapy for any recipient
				  who meets the criteria established by Medicare pursuant to sections 1861 (s)
				  (6) and 1862 (a) (1) (A) of the Social Security Act,
				  42 C.F.R.
				  410.38 and Medicare Carrier's Manual, Chapter
				  II, Coverage and Limitations, Section 2100.5 including Section 60-4 in the
				  Coverage Issues Appendix of the Medicare Coverage Issue Manual, and as they may
				  be amended from time to time. This includes all medical criteria including
				  medical documentation, laboratory and health conditions, with the exception of
				  (a) (1) and (2) of this section.
(1) A
				measure of arterial oxygen saturation obtained by ear or pulse oximetry, will
				also be acceptable when ordered and evaluated by the attending physician
and
performed under his/her supervision or when performed by a
				Licensed Nurse, Physician, a licensed supplier of Laboratory services, a
				Registered Respiratory Therapist or a Certified Respiratory Therapy Technician
				as recognized by the National Board Of Respiratory Care.
(2) Those recipients residing in the home and
				receiving oxygen therapy prior to the effective date of this regulation may
				continue to do so as long as the oxygen therapy is continuous. For the purpose
				of this provision continuous means that oxygen therapy remains necessary and is
				actively being used by the recipient at the beginning of every rental month. If
				at anytime the service is discontinued and is prescribed again at a later time
				the requirements set forth under Sections 1861 (s) (6) and 1862 (a) (1) (A) of
				the Social Security Act,
				42 C.F.R.
				410.38 and Medicare Carrier's Manual, Chapter
				II, Coverage and Limitations, Section 2100.5 including Section 60-4 in the
				Coverage Issues Appendix of the Medicare Coverage Issue Manual and as they may
				be amended from time to time must be met. All residents of longterm care
				facilities must meet the requirements as set forth in the Medicare Carrier's
				Manual, Chapter II, Coverage and Limitations, section 2100.5; and as they may
				be amended from time to time; effective upon passage of these regulations in
				order to receive oxygen therapy services from a MEDS provider. Oxygen
				concentrators owned by nursing facilities may be used at the discretion of the
				nursing facility.
(3) Prescription
				Requirements
The Certification of Medical Necessity form (Medicare Form
				  HCFA-484) shall be used for all orders of oxygen therapy. This fully completed
				  form must be signed by the prescribing physician. The form shall be completed
				  (1) annually for patients who require oxygen on a lifetime basis, and (2) every
				  six (6) months for all other patients requiring oxygen.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Title XIX Rates for Community Health Centers › Section 17-134d-85 - Policy and procedures governing the billing and payment for oxygen therapy on behalf of title XIX medicaid recipients

Current through July 10, 2024
(a)
Billing
				Procedure
(1) Form H.C.F.A. 1500
				"Health Insurance Claim Form" is used to bill for oxygen therapy. The bill is
				mailed to the Department's claims processing agent.
(2) All claims submitted for payment which
				include prior authorized items must include the authorization number from the
				current authorization.
(3) All
				claims submitted for services not requiring prior authorization must include
				the name of the prescribing physician.
(4) The provider shall enter its usual and
				customary charge on the claim form.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-139 - Scope

Current through July 10, 2024
Sections
				  17-134d-140 to
				  17-134d-149
				  inclusive set forth the requirements for payment of Case Management Services
				  provided by the State of Connecticut Department of Mental Health to persons
				  determined eligible to receive services under Connecticut's Medical Assistance
				  Program pursuant to Section 17-134d of the General Statutes of
				  Connecticut.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-140 - Definitions

Current through July 10, 2024
For the purposes of Regulation Sections
				  17-134d-139
				  through
				  17-134d-149, the
				  following definitions shall apply:
(a)
				"Case Manager" means the person employed by the Department of Mental Health or
				performing provider responsible for assessing the eligible person's needs,
				developing a plan of services with the eligible person and others to meet those
				needs, linking the eligible person to the services identified in the plan of
				services, supporting and monitoring the eligible person in the utilization of
				the identified services, advocating on the eligible person's behalf and
				maintaining client files and recording services provided.
(b) "Case Management Services" means the
				continuum of assessment, planning, linkage, support and advocacy activities
				systematically carried out by an individual case manager that are available to
				assist and enable an eligible person to gain access to needed medical,
				clinical, social, educational or other services.
(c) "Collateral Contact" means a contact with
				other individuals/agencies within the person's natural support
				networks.
(d) "Department" means
				the State of Connecticut Department of Income Maintenance.
(e) "Eligible Person" means a person who
				qualifies to receive services under the Connecticut Medical Assistance Program
				pursuant to Section 17-134b of the General Statutes of Connecticut, as amended
				from time to time, and regulations promulgated pursuant to Section 17-134d of
				the General Statutes of Connecticut.
(f) "Needed Services" means any medical,
				clinical, social, educational or other services identified as required by an
				eligible person in a plan of services.
(g) "Performing Provider" means any
				designated grantee agency, or other entity employed by the Department of Mental
				Health in the delivery of case management services to eligible
				persons.
(h) "Plan of Services"
				means a written document which is developed on an annual basis identifying an
				eligible person's unique set of needed services and the public or private
				entities that will or may provide those services.
(i) "Representative" means any person,
				organization or entity authorized to act on behalf of an eligible person
				through an agreement, or, a family member of court appointed delegate of the
				eligible person pursuant to provisions in the General Statutes of Connecticut,
				as amended from time to time.
(j)
				"Target Group" means those eligible persons who are part of the target
				population of the Department of Mental Health as defined in Department of
				Mental Health policy and amended from time to time.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-141 - Provider participation

Current through July 10, 2024
In order to participate in the Connecticut Medical Assistance
				  Program and receive payment from the Department for the case management
				  services rendered, the Department of Mental Health shall:
(1) provide case management services directly
				or via its performing providers pursuant to all applicable provisions of
				federal and state statutes and regulations promulgated thereunder;
(2) meet and maintain all Department provider
				enrollment requirements;
(3) have a
				valid Connecticut Medical Assistance Program provider agreement on file with
				the Department which is signed by the Department of Mental Health Commissioner
				or the Commissioner's designee. The provider agreement will be effective upon
				the Department approved date of enrollment. The provider agreement specifies
				conditions and terms (federal and state regulations, standards and statutes)
				which govern the Connecticut Medical Assistance Program and to which the
				Department of Mental Health is mandated to adhere in order to participate in
				the program;
(4) assign an
				individual case manager to serve as the person primarily responsible for case
				management services or assure that an individual case manager is assigned by
				one of its performing providers; and
(5) insure that, pursuant to subsection
				17-134d-144(b)
				below, a case manager is an individual employed by the Department of Mental
				Health or one of its performing providers.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-142 - Eligibility

Current through July 10, 2024
Payment for case management services is available only on
				  behalf of all persons specified as members of the target group, pursuant to
				  subsection (a) of 17-134d-144, who are eligible to receive services pursuant to
				  the Connecticut Medical Assistance Program subject to conditions and
				  limitations which apply to such case management services.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-143 - Services covered

Current through July 10, 2024
Case management services may include the continuum of
				  activities systematically carried out by an individual case manager that are
				  available to assist and enable an eligible person to gain access to needed
				  medical, clinical, social, educational or other services. At a minimum, such
				  case management services shall include the provision of one or more of the
				  following types of case management activities, through either direct or
				  collateral contact, in a calendar month:
(1) assessing the eligible person's
				needs;
(2) developing a plan of
				services with the eligible person and others to meet those needs;
(3) linking the eligible person to the
				services identified in the plan of services;
(4) supporting and monitoring the eligible
				person in the utilization of the identified services; and
(5) advocating on the eligible person's
				behalf.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-144 - Limitations

Current through July 10, 2024
(a)
Target Group Limitations
(1) Payment for case management services is
				limited to case management services provided to eligible persons with chronic
				mental illness as defined in the Department of Mental Health target population
				definition, as amended from time to time.
Connecticut Administrative Code › Title 17 - Public Assistance and Welfare Services › 134d - Medical Assistance › Requirements for Payment of Case Management Services for Persons with Chronic Mental Illness › Section 17-134d-145 - Need for services

Current through July 10, 2024
Payment for case management services will be made by the
				  Department only if the eligible person evidences a need for case management
				  services, and if they meet the requirements to receive services from the
				  Department of Mental Health in accordance with its target population definition
				  and rules regarding provision of services, as amended from time to
				  time.