Bill Text: CT SB00236 | 2012 | General Assembly | Comm Sub
Bill Title: An Act Concerning Reimbursement Of Emergency Room Physicians For Treatment Of Medicaid Recipients.
Sponsorship: Committee Bill
Status: (Introduced - Dead) 2012-05-01 - Moved to Foot of the Calendar, Senate [SB00236 Detail]
Download: Connecticut-2012-SB00236-Comm_Sub.html
General Assembly |
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February Session, 2012 |
*_____SB00236APP___041612____* |
AN ACT CONCERNING REIMBURSEMENT OF EMERGENCY ROOM PHYSICIANS FOR TREATMENT OF MEDICAID RECIPIENTS.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Subsection (d) of section 17b-239 of the 2012 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2012):
(d) The state shall also pay to such hospitals for each outpatient clinic and emergency room visit a reasonable rate to be established annually by the commissioner for each hospital, such rate to be determined by the reasonable cost of such services. The Commissioner of Social Services shall set and pay a separate and distinct rate for an emergency room physician who (1) provides professional services to a Medicaid beneficiary in the emergency room of a hospital, including services provided on the same day the beneficiary is admitted to the hospital, and (2) is not compensated by the hospital, either through a salary or a percentage of fees, to provide such services in the hospital. The rate paid by the commissioner for the emergency room physician's professional services shall be paid separately from the rate paid to such hospital for the emergency room visit. The emergency room visit rates in effect June 30, 1991, shall remain in effect through June 30, 1993, except those which would have been decreased effective July 1, 1991, or July 1, 1992, shall be decreased. Nothing contained herein shall authorize a payment by the state for such services to any hospital in excess of the charges made by such hospital for comparable services to the general public. For those outpatient hospital services paid on the basis of a ratio of cost to charges, the ratios in effect June 30, 1991, shall be reduced effective July 1, 1991, by the most recent annual increase in the consumer price index for medical care. For those outpatient hospital services paid on the basis of a ratio of cost to charges, the ratios computed to be effective July 1, 1994, shall be reduced by the most recent annual increase in the consumer price index for medical care. The emergency room visit rates in effect June 30, 1994, shall remain in effect through December 31, 1994. The Commissioner of Social Services shall establish a fee schedule for outpatient hospital services to be effective on and after January 1, 1995, and may annually modify such fee schedule if such modification is needed to ensure that the conversion to an administrative services organization is cost neutral to hospitals in the aggregate and ensures patient access. Utilization shall not be a factor in determining cost neutrality. Except with respect to the rate periods beginning July 1, 1999, and July 1, 2000, such fee schedule shall be adjusted annually beginning July 1, 1996, to reflect necessary increases in the cost of services. Notwithstanding the provisions of this subsection, the fee schedule for the rate period beginning July 1, 2000, shall be increased by ten and one-half per cent, effective June 1, 2001. Notwithstanding the provisions of this subsection, outpatient rates in effect as of June 30, 2003, shall remain in effect through June 30, 2005. Effective July 1, 2006, subject to available appropriations, the commissioner shall increase outpatient service fees for services that may include clinic, emergency room, magnetic resonance imaging, and computerized axial tomography.
This act shall take effect as follows and shall amend the following sections: | ||
Section 1 |
July 1, 2012 |
17b-239(d) |
HS |
Joint Favorable Subst. |
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APP |
Joint Favorable |