Substitute Bill No. 6305: SustiNet Plan Implementation

• Establishes the SustiNet Plan Authority as a public instrumentality with a 15-member board of directors to oversee a comprehensive state health insurance program covering state employees, Medicaid enrollees, and other populations through multiple coordinated health plans.

• Creates six interconnected SustiNet plan categories (A through E, plus new SustiNet G) consolidating existing programs including Medicaid, HUSKY Plan Parts A and B, Charter Oak Health Plan, and state employee coverage under unified governance effective January 1, 2012.

• Authorizes the SustiNet Authority to implement delivery system and payment reforms including patient-centered medical homes, alternative payment methods, chronic disease management, and value-based purchasing to control costs and improve health care quality.

• Permits nonstate public employers, municipal-related employers, nonprofit employers, and small employers to purchase coverage through the state employee plan (starting July 1, 2011) and through new SustiNet G beginning January 1, 2012, with phased expansion to all individuals and employers by January 1, 2014.

• Establishes a basic health program for individuals with income up to 200 percent of federal poverty level ineligible for Medicaid, funded with federal revenues under the Affordable Care Act, with excess federal funds directed to increase provider reimbursement rates.