New Federal Medicaid Access Regulations
Effective January 1, 2016, the federal Centers for Medicare & Medicaid Services (CMS) adopted regulations at 42 C.F.R. §§ 447.203 and 447.204 that require state Medicaid programs to ensure Medicaid members have access to covered services. Please follow this link
to read the federal regulations. The Department of Social Services (DSS), which administers Medicaid in Connecticut, is committed to ensuring that Medicaid members can access the services they need. DSS is also committed to complying with the federal access requirements.
Medicaid Access Plan
The federal access regulations require DSS to prepare an access monitoring review plan (“access plan”), which must analyze how Medicaid members have access to medically necessary covered services, including analysis of data sources, methodologies, baselines, assumptions, trends, factors, and thresholds. States must also consider information about access from providers, members, and other stakeholders.
This webpage provides information only about the access plan. This page is not designed to fix immediate access problems (see phone numbers below if you are a Medicaid member who needs help finding a doctor or other provider). Please do not send any personally sensitive information such as social security numbers or Medicaid ID numbers with your comments about the access plan. Please follow the links below to read the final Access Monitoring Review Plan and Appendix 1 of the plan.
How to Send DSS Comments About the Access Plan
If you wish to send DSS comments about the access plan, please include your name and contact information with your comments. You may send comments by email or by mail. Comments will be accepted until August 25, 2016. In the subject line of your comments, please reference “Access Plan Comments” and please include your name and contact information in the body of your comments. Please do not include any personally sensitive information in your comments, such as social security numbers or Medicaid ID numbers.
Send comments by mail to:
Department of Social Services – Medical Policy
55 Farmington Ave – 9th Floor
Hartford CT, 06105
Attn: Access Plan Comments
Medicaid Members Who Need Help Finding a Doctor or Other Provider
If you are a Medicaid member who needs help finding a doctor or other provider right now, please contact member services on your Medicaid card or one of the following:
For Help Finding a MEDICAL
provider, please contact HUSKY Health / Community Health Network (CHNCT) Call 1-800-859-9889 (or 711 if you are hearing impaired), open Monday - Friday 8:00 a.m. – 6:00 p.m. Or visit the HUSKY Health website at www.huskyhealth.com
For Help Finding a BEHAVIORAL HEALTH
please contactCT Behavioral Health Partnership / Beacon Health Options CT Call 1-877-552-8247 (TTY: 1-866-218-0525), open Monday -Friday 9:00 a.m. – 7:00 p.m. Or visit the CT Behavioral Health Partnership website at www.ctbhp.com
For Help Finding a DENTAL
Provider, pleaser contact CT Dental Health Partnership / BeneCare Call 1-855-283-3682, open Monday - Friday 8:00 a.m. -5:00 p.m. Or visit the CT Dental Health Partnership website: www.ctdhp.com