CT HB07191

Medicaid provider rates must be phased in starting July 1, 2025 to reach at least 75% of Medicare rates by June 30, 2028, with services lacking Medicare equivalents benchmarked against rates in Maine, Massachusetts, New Jersey, New York, and Oregon

Federally qualified health center encounter rates must be rebased by December 31, 2025 using fiscal year 2024 costs, with new rates not falling below previous rates and annual increases tied to the Medicare Economic Index starting January 1, 2026

Provider rates for pediatric and adult health care services must be adjusted to achieve parity, and existing fee schedules must be streamlined so all providers are reimbursed using the same schedule

Federally qualified health centers can request rate adjustments for scope-of-service changes, with the Department of Social Services required to meet within 30 days and issue decisions within 120 days, including an appeals process

The Council on Medical Assistance Program Oversight must conduct ongoing reviews of Medicaid reimbursement rates and file annual reports starting January 15, 2026 with recommendations on appropriations needed to ensure adequate provider compensation