Sec. 17b-28a. Waiver Application Development Council. Medicaid waiver unit.
Sec. 17b-28a. Waiver Application Development Council. Medicaid waiver
unit. (a) There is established a Waiver Application Development Council that shall be
composed of the following members: The chairpersons and ranking members of the
joint standing committee of the General Assembly having cognizance of matters relating
to appropriations, or their designees; the chairpersons and ranking members of the joint
standing committee of the General Assembly having cognizance of matters relating to
human services, or their designees; the chairpersons and ranking members of the joint
standing committee of the General Assembly having cognizance of matters relating to
public health, or their designees; the Commissioner of Social Services, or his designee;
the Commissioner of Public Health, or his designee; the Commissioner of Mental Health
and Addiction Services, or his designee; the Commissioner of Developmental Services,
or his designee; the Secretary of the Office of Policy and Management, or his designee;
the State Comptroller, or his designee; a representative of advocacy for mental retardation to be appointed by the president pro tempore of the Senate; a representative of
advocacy for the elderly to be appointed by the majority leader of the Senate; a representative of the nursing home industry to be appointed by the minority leader of the Senate;
a representative of the home health care industry, independent of the nursing home
industry, to be appointed by the speaker of the House of Representatives; a representative
of the mental health profession to be appointed by the majority leader of the House of
Representatives; a representative of the substance abuse profession to be appointed by
the minority leader of the House of Representatives; a health care provider to be appointed by the president pro tempore of the Senate; two elderly consumers of Medicaid
services who are also eligible for Medicare, to be appointed by the speaker of the House
of Representatives; a representative of the managed care industry, to be appointed by
the president pro tempore of the Senate; a social services care provider, to be appointed
by the majority leader of the House of Representatives; a family support care provider,
to be appointed by the majority leader of the Senate; two persons with disabilities who
are consumers of Medicaid services, one to be appointed by the president pro tempore
of the Senate and one to be appointed by the minority leader of the House of Representatives; a representative of legal advocacy for Medicaid clients, to be appointed by the
minority leader of the Senate; and six members of the General Assembly, one member
appointed by the president pro tempore of the Senate; one member appointed by the
majority leader of the Senate; one member appointed by the minority leader of the
Senate; one member appointed by the speaker of the House of Representatives; one
member appointed by the majority leader of the House of Representatives; and one
member appointed by the minority leader of the House of Representatives. The council
shall be responsible for advising the Department of Social Services, which shall be the
lead agency in the development of a Medicaid Research and Demonstration Waiver
under Section 1115 of the Social Security Act for application to the Office of State
Health Reform of the United States Department of Health and Human Services by May
1, 1996. The council shall advise the department with respect to specific provisions
within the waiver application, including but not limited to, the identification of populations to be included in a managed care program, a timetable for inclusion of distinct
populations, expansion of access to care, quality assurance and grievance procedures
for consumers and providers. The council shall also advise the department with respect
to the goals of the waiver, including but not limited to, the expansion of access and
coverage, making state health spending more efficient and to the reduction of uncompensated care.
(b) There is established a Medicaid waiver unit within the Department of Social
Services for the purposes of developing the waiver under subsection (a) of this section.
The Medicaid waiver unit's responsibilities shall include but not be limited to the following: (1) Administrating the Medicaid managed care program, established pursuant to
section 17b-28; (2) contracting with and evaluating prepaid health plans providing Medicaid services, including negotiation and establishment of capitated rates; (3) assessing
quality assurance information compiled by the federally required independent quality
assurance contractor; (4) monitoring contractual compliance; (5) evaluating enrollment
broker performance; (6) providing assistance to the Insurance Department for the regulation of Medicaid managed care health plans; and (7) developing a system to compare
performance levels among prepaid health plans providing Medicaid services.
(P.A. 95-257, S. 7, 58; P.A. 96-268, S. 30, 34; June 18 Sp. Sess. P.A. 97-2, S. 114, 165; June 18 Sp. Sess. P.A. 97-8,
S. 29, 88; P.A. 07-73, S. 2(b).)
History: P.A. 95-257, S. 7 effective July 1, 1995 (Revisor's note: A reference in Subsec. (b)(7) to "Department of
Insurance" was changed editorially by the Revisors to "Insurance Department" for consistency with customary statutory
usage); P.A. 96-268 added the chairpersons and ranking members of the committee having cognizance of matters relating
to human services, or their designees, to the Waiver Application Development Council, effective July 1, 1996; June 18
Sp. Sess. P.A. 97-2 amended Subsec. (a) by adding the chairpersons and ranking members of the joint standing committee
of the General Assembly having cognizance of matters relating to public health, or their designees, the Commissioner of
Social Services, or his designee, the Commissioner of Public Health, or his designee, the Commissioner of Mental Health
and Addiction Services, or his designee, the Commissioner of Mental Retardation, or his designee, the Secretary of the
Office of Policy and Management, or his designee, the State Comptroller, or his designee, a representative of advocacy
for mental retardation to be appointed by the president pro tempore of the Senate, a representative of advocacy for the
elderly to be appointed by the majority leader of the Senate, a representative of the nursing home industry to be appointed
by the minority leader of the Senate, a representative of the home health care industry, independent of the nursing home
industry, to be appointed by the speaker of the House of Representatives, a representative of the mental health profession
to be appointed by the majority leader of the House of Representatives, a representative of the substance abuse profession
to be appointed by the minority leader of the House of Representatives, a health care provider to be appointed by the
president pro tempore of the Senate, two elderly consumers of Medicaid services who are also eligible for Medicare, to
be appointed by the speaker of the House of Representatives, a representative of the managed care industry, to be appointed
by the president pro tempore of the Senate, a social services care provider, to be appointed by the majority leader of the
House of Representatives, a family support care provider to be appointed by the majority leader of the Senate, two person
with disabilities who are consumers of Medicaid services, one to be appointed by the president pro tempore of the Senate
and one to be appointed by the minority leader of the House of Representatives, and a representative of legal advocacy for
Medicaid clients, to be appointed by the minority leader of the Senate to the Waiver Application Development Council
and made conforming changes, effective July 1, 1997; June 18 Sp. Sess. P.A. 97-8 deleted Subsec. (b)(6) re provision of
data to Connecticut Health Care Data Institute, renumbering remaining Subdivs. accordingly, effective July 1, 1997;
pursuant to P.A. 07-73 "Commissioner of Mental Retardation" was changed editorially by the Revisors to "Commissioner
of Developmental Services", effective October 1, 2007.