CT SB00814

Establishes a voluntary program within the Department of Public Health to certify and promote Accountable Care Organizations (ACOs) that coordinate health care services to improve quality, value, and accountability, effective October 1, 2015.

Requires the Commissioner of Public Health to adopt regulations in consultation with the Attorney General, health care providers, health insurance carriers, and patient advocates, establishing certification criteria, quality standards, reporting requirements, and governance structures for ACOs.

Mandates that ACO governing bodies include an administrative officer, medical director, and representatives of Medicaid/HUSKY recipients and consumers, with at least 75 percent control held by ACO participants, and prohibits incentives that discourage appropriate care or deny medically necessary services.

Authorizes ACOs to enter into payment arrangements with health insurance carriers, including capitation and incentive payment models, and permits cooperative arrangements among competitors with state action immunity under antitrust laws.

Requires ACOs to submit articles of incorporation, bylaws, annual financial reports, and descriptions of provider participation standards to the Commissioner of Public Health, with the Commissioner reporting annually to the General Assembly on program continuation and modifications.