Sec. 17a-460c. Connecticut Mental Health Center: Provider agreements.
Sec. 17a-460c. Connecticut Mental Health Center: Provider agreements. (a)
The center, when authorized by the commissioner, may enter into provider agreements
and other contractual arrangements with Medicaid and Medicare managed care plans,
governmental health plans, health maintenance organizations, health insurance plans,
employer and union health plans, preferred provider organizations, physician-hospital
organizations, managed care plans, networks and other similar arrangements or plans
offered by insurers, third-party payers or other entities offering health care plans to their
members or employees and their dependents.
(b) The agreements and other contractual arrangements identified in subsection (a)
of this section may include plans and arrangements certified by the Department of Social
Services, the Department of Mental Health and Addiction Services, or the federal Centers for Medicare and Medicaid Services, to provide services to Medicaid, Medicare,
state-administered general assistance, Department of Mental Health and Addiction Services or Centers for Medicare and Medicaid Services beneficiaries, as well as private
plans and arrangements satisfactory to the commissioner.
(c) Participation in the agreements and other contractual arrangements identified
in this section and approved by the commissioner shall not be subject to the review and
approval of other state agencies except as otherwise required by law.
(d) To the extent the commissioner permits, the center may bill and accept as reimbursement for services provided pursuant to the agreements and other contractual arrangements identified in this section negotiated rates, including rates based on charges,
discounted charges, per diem or per case rates or other forms of reimbursement. Such
reimbursement shall be subject to review or approval by the Secretary of the Office of
Policy and Management based on demonstrated impact on federal reimbursement.
(June 18 Sp. Sess. P.A. 97-8, S. 48; P.A. 03-19, S. 36; P.A. 04-76, S. 6.)
History: P.A. 03-19 replaced "Health Care Financing Administration" with "Centers for Medicare and Medicaid Services" in Subsec. (b), effective May 12, 2003; P.A. 04-76 amended Subsec. (b) by replacing reference to "general assistance"
with reference to "state-administered general assistance".