OLR Bill Analysis

sHB 5297 (as amended by House “A” )*

AN ACT CONCERNING STATE-WIDE EXPANSION OF THE PRIMARY CARE CASE MANAGEMENT PILOT PROGRAM.

SUMMARY:

This bill requires the Department of Social Services (DSS) to expand the HUSKY Primary Care pilot program to include primary care providers in Putnam (by July 1, 2010) and Torrington (by October 1, 2010). The bill permits the DSS commissioner to seek a federal waiver to make these expansions. HUSKY Primary Care is the state's primary care case management program, which is an alternative care model available to HUSKY A enrollees.

The commissioner must report on the program's expansion to the Human Services and Appropriations committees by July 1, 2011.

The bill also removes obsolete language and makes technical changes.

*House Amendment A” (1) eliminates the requirement that DSS continue to add two municipalities until the program is operating in every county in the state and (2) delays until October 1, 2010 the date by which the Torrington expansion must occur.

EFFECTIVE DATE: Upon passage

BACKGROUND

HUSKY Primary Care

Since early 2009, certain HUSKY A families have had the option of enrolling in HUSKY Primary Care. The family is matched with a primary care provider (PCP) or providers who provide primary care services and also manage the family's care, including making referrals to specialists. The PCPs are paid a monthly fee for managing the HUSKY recipient's care in addition to any reimbursement they receive for providing medical services. The pilot serves as an alternative to the managed care organizations, which also serve the HUSKY A population.

The pilot program serves four cities—Hartford, New Haven, Waterbury, and Windham (geographic areas) and the towns contiguous to them. Currently, the program is not operating in Fairfield, Litchfield, and Middlesex counties. Torrington is part of Litchfield County and Putnam is in Windham County.

DSS operates its HUSKY A program under a federal Medicaid waiver. A 2009 amendment to the waiver calls for extending the program after July 15, 2010 to additional areas that the DSS commissioner approves provided (1) an independent evaluation finds that primary care case management contains costs and improves quality and access to health care and (2) an adequate number of PCPs for both children and adults have applied to participate in the program.

As of April 2010, there were 359 HUSKY A recipients enrolled in the program and 237 providers participating.

COMMITTEE ACTION

Human Services Committee

Joint Favorable Substitute

Yea

14

Nay

5

(03/18/2010)