HB 7008 — AN ACT CONCERNING MEDICAID REIMBURSEMENT FOR LONG-ACTING REVERSIBLE CONTRACEPTIVES PROVIDED AT FEDERALLY QUALIFIED HEALTH CENTERS.

AN ACT CONCERNING AMEDICAID MEDICAID-FUNDEDREIMBURSEMENT PILOT PROGRAM FOR LONG-ACTING REVERSIBLE CONTRACEPTIVES.CONTRACEPTIVES PROVIDED AT FEDERALLY QUALIFIED HEALTH CENTERS.

General Assembly   RaisedSubstitute Bill No.

7008 January Session, 2017   LCO*_____HB07008HS_APP030317____* No.AN ACT CONCERNING MEDICAID REIMBURSEMENT FOR LONG-ACTING REVERSIBLE CONTRACEPTIVES PROVIDED AT FEDERALLY QUALIFIED HEALTH CENTERS.

3417   *03417_______HS_* Referred to Committee on HUMAN SERVICES   Introduced by:

  (HS)   AN ACT CONCERNING A MEDICAID-FUNDED PILOT PROGRAM FOR LONG-ACTING REVERSIBLE CONTRACEPTIVES.

(NEW) (Effective Julyfrom 1,passage) 2017) (a) For purposes of this section, (1) "long-acting reversible contraceptive" means a birth control method that may be effective for years, is reversible and includes, but is not limited to, intrauterine devices and implants.contraceptive implants, and (2) "federally qualified health center" means a facility that serves a medically underserved area or population, provides family planning or obstetric services and qualifies for funding under Section 330 of the Public Health Service Act, 42 USC 254b.

(b) The Commissioner of Social Services shall establishseek afederal one-yearapproval pilotfor programan inamendment Hartfordto andthe NewMedicaid Havenstate plan to promoteprovide thea useseparate rate of long-actingMedicaid reversiblereimbursement contraceptivesto amonga notfederally morequalified thanhealth onecenter thousandfor primarilythe adolescentactual Medicaidacquisition recipientscost toof detera thelong-acting ratereversible ofcontraceptive unwantedprovided pregnanciesat andthe associatedrequest costs.of a Medicaid recipient.

(c) The commissionerrate shallof reallocatereimbursement notfor morea thanlong-acting eightreversible hundredcontraceptive thousandshall dollarsbe in anyaddition Medicaidto fundingreimbursement used for family planning to fund the pilotfederally programqualified andhealth shallcenter developfor athe Medicaid reimbursementrecipient's systemvisit thatwith encouragesthe hospitals, pharmacists and other health care providersprovider towho participateprovides in the program.contraceptive.

Such system may include, but is not limited to:

(1) Separate, additional Medicaid reimbursement for the provision of long-acting reversible contraceptives in addition to an obstetric fee when such contraceptives are provided immediately after a participating Medicaid recipient gives birth in a hospital;

(2) a higher, separate rate of Medicaid reimbursement for provision of such contraceptive during an outpatient visit to a participating provider;

(3) direct reimbursement with a dispensing fee add-on to pharmacies that provide such contraceptives to health care providers for participating Medicaid recipients;

and (4) waiving preauthorization protocols for the provision of such contraceptives to participating Medicaid recipients.

(d) As part of the pilot program, the commissioner shall provide:

(1) Training for providers and staff regarding the provision of long-acting reversible contraceptives, including, but not limited to, counseling strategies and management of any side effects;

(2) technical assistance regarding issues such as proper coding and billing procedures to ensure timely Medicaid reimbursement;

and (3) marketing and outreach regarding the availability and advantages of such contraceptives among other currently available contraceptive services.

(e) Not later than October 1, 2018, the commissioner shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, on the pilot program to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies, human services and public health.

The report shall include, but need not be limited to:

(1) Data on any reduction in unintended pregnancies and subsequent births, especially among adolescents, in Hartford and New Haven during the pilot program;

(2) the number and location of family planning providers, obstetricians, hospitals and pharmacists that participated in the pilot program;

(3) the average cost per participating Medicaid recipient;

(4) estimated savings in Medicaid dollars related to any reduction in pregnancies related to the pilot program;

and (5) any obstacles to successful outcomes of the pilot program.

(f) The commissioner may seek federal and state grants to support the pilot program and any technical assistance provided by the federal Centers for Medicare and Medicaid Services for programs encouraging the use of long-acting reversible contraceptives among Medicaid recipients.

Section 1 Julyfrom 1,passage 2017 New section StatementHS ofJoint Purpose:Favorable Subst.

ToC/R establishAPP a pilot program to promote the deterrence of unwanted pregnancies among Medicaid recipients and associated costs by promoting the use of long-acting reversible contraceptives.

[Proposed deletions are enclosed in brackets.

Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]