Sec. 17b-242a. Medicaid home health services. Prior authorization requirements. Regulations.
Sec. 17b-242a. Medicaid home health services. Prior authorization requirements. Regulations. The Commissioner of Social Services shall establish prior authorization procedures under the Medicaid program for home health services, such that prior
authorization shall be required for skilled nursing visits that exceed two per week and
for home health aide visits that exceed fourteen hours per week, except that no provider
shall be required to submit a prior authorization request for a home health service for
the same client more than once a month. The Commissioner of Social Services may
contract with an entity for administration of any such aspect of prior authorization or
may expand the scope of an existing contract with an entity that performs utilization
review services on behalf of the department. The commissioner, pursuant to section
17b-10, may implement policies and procedures necessary to administer the provisions
of this section while in the process of adopting such policies and procedures as regulations, provided the commissioner prints notice of intent to adopt regulations in the Connecticut Law Journal not later than twenty days after the date of implementation. Policies
and procedures implemented pursuant to this section shall be valid until the time final
regulations are adopted.
(P.A. 05-280, S. 46; P.A. 06-188, S. 15; 06-196, S. 133.)
History: P.A. 05-280 effective July 1, 2005; P.A. 06-188 added prior authorization requirement for home health aide
visits that exceed 14 hours per week, added exception that providers shall not be required to submit a prior authorization
request for a home health service for the same client more than once a month and deleted provision re revisions to a prior
authorization request previously received during the month, effective July 1, 2006; P.A. 06-196 made a technical change,
effective June 7, 2006.