Bill > HB07191

This bill aims to improve Medicaid reimbursement rates for healthcare providers by implementing a phased approach to rate increases over three years, starting July 1, 2025. The bill requires the Commissioner of Social Services to gradually raise Medicaid provider rates to reach at least 75% of Medicare rates or an equivalent percentage based on a benchmark of five states (Maine, Massachusetts, New Jersey, New York, and Oregon). The commissioner must ensure rate parity between pediatric and adult healthcare services and streamline existing fee schedules to create a more uniform reimbursement system. For federally qualified health centers, the bill introduces a new process for rebasing encounter rates based on the center's costs and patient encounters in fiscal year 2024, with protections to ensure rates do not decrease. Additionally, the bill establishes an annual automatic rate increase tied to the Medicare Economic Index (a measure of inflation for physicians' practice costs) and creates a new oversight mechanism through the Council on Medical Assistance Program Oversight to systematically review and report on Medicaid provider reimbursement rates. The goal is to ensure adequate compensation for healthcare providers, maintain a sufficient provider pool, and improve access to high-quality care for Medicaid recipients.

Budget and Finance, Health and Social Services

Human Services Committee (Joint)

https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=HB07191&which_year=2025