June 9, 2005

Highlights of the 2005-2007 Budget: HUSKY Program

Sources:  HB No 7000, LCO 8230, OFA “Highlights of Biennial budget"

ü      Re-establish HUSKY A eligibility for parents/caregivers of children with family incomes between 100-150% FPL  (Sec. 1, a). Impose cost sharing requirements on all HUSKY A parent/caregivers with incomes exceeding 100% FPL (sec 1, i):

o       $25 per month per parent/caregiver

o       $1 co-payment for outpatient medical services.

ü      Reduce Transitional Medicaid Assistance (TMA) from 2 years to one year for families that become ineligible for medical assistance under Section 1931 of the SSA due to income from employment. (Sec 1, f).

ü      Eliminate self-declaration of income for HUSKY A & B applications.(Sec 5, h).

ü      Health Plan lock-in:  clients enrolled in a managed care plan in HUSKY A or B shall remain enrolled in the health plan for 12 months unless there is “good cause” reason, to the satisfaction of the commissioner, to change managed care plans. (Sec 9, i).

ü      New/increased cost sharing responsibility for HUSKY B:

o       Impose new cost sharing for Band 1 (185-235% FPL); the annual aggregate of the combined premiums & co-payments cannot exceed 5% of the family’s gross annual income.

o       Increase premium requirement on families in Band 2 (>235-300%FPL).

o       Each MCO will monitor member cost sharing payments.

ü      Re-established Presumptive Eligibility for HUSKY A children. (Sec 9,f).

ü      Implement “expedited eligibility” for pregnant women applicants to HUSKY A. (Sec 8 b,c).  Upon receipt of all required information:

o       “Emergency” applications will be processed no later than 24 hours.

o       “Non-emergency” applications will be processed no later than five (5) calendar days.

o       DSS shall submit biannual reports to the Medicaid Council on agency’s compliance with these administrative processing requirements.

ü      DSS shall develop a new contract for an enrollment broker upon the expiration of the current contract, with specified performance measures, applicable sanctions. The new contract period will not exceed 7 years. (Sec 9, h).

ü      Behavioral Health Partnership (DSS & DCF) provisions, including implementation of an integrated BHB system, establishment of an Oversight Council, scope of oversight, administrative entity (Sec 93-102).

ü      Under Medicaid, DSS shall develop & implement a 2-year pilot for 100 individual ages 19-20 with co-occurring chronic health conditions that are ineligible for SAGA due to parent income.