CT SB00191

Commissioner of Social Services shall reimburse federally qualified health centers using an all-inclusive encounter rate per client encounter based on the prospective payment system required by 42 USC 1396a(bb)

Multiple encounters with different or same health professionals on the same day for the same service type shall count as a single encounter for reimbursement purposes, except when patient suffers new illness or injury requiring additional diagnosis and treatment

Federally qualified health centers must complete nonemergency periodic dental services (examination, prophylaxis, and radiographs) in one visit and cannot split these services across different dates to bill for separate encounters

A second visit to complete services normally included in a nonemergency periodic dental visit is not eligible for reimbursement unless medically necessary and clearly documented in the patient's dental record

The act becomes effective July 1, 2022, and amends Connecticut General Statutes section 17b-245b