Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
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Connecticut Mirror

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Federal Policy·6d ago

CMS Proposes Reduced Payment for Same-Day Evaluation and Procedure Services

CMS has proposed a rule to reduce Medicare payment for evaluation and management services performed on the same day as a procedure, paying full price for the more expensive service and a reduced rate for the second to account for shared costs. The change would affect how providers bill Medicare Part B for same-day services, such as when a dermatologist evaluates a patient and immediately performs a removal procedure during the same visit. The proposal aims to eliminate duplicative billing and reduce out-of-pocket costs for Medicare beneficiaries, who currently pay copayments based on the full rate for both services. The rule would lower costs for patients and taxpayers by preventing Medicare from paying twice for overlapping service components.

State Policy·CT·11d ago

Connecticut GOP Candidate Proposes $336M Medicaid Cut, Managed Care Transition

Connecticut Republican gubernatorial candidate Ryan Fazio announced a tax cut plan that would reduce Medicaid spending by $336 million annually by 2031 through eliminating coverage for undocumented residents, fraud reduction efforts, and transitioning to a managed care model for the state's Medicaid program. The proposal would also cut $1.2 billion in annual state spending and $500 million in borrowing. The managed care transition faces strong opposition from the Democratic-controlled state legislature. The plan's fiscal projections rely on outdated revenue forecasts and do not account for recent investments in municipal aid, childcare, and social services.

State Policy·CT·16d ago

Connecticut Poll Shows Voter Support for Increasing State Medicaid Spending Amid Federal Cuts

A poll of 602 Connecticut voters found 86% support using state surplus funds to offset federal cuts to social services, including Medicaid, and 54% favor adjusting budget caps to increase funding. An estimated 110,000 low-income adults in the HUSKY D Medicaid program face coverage loss in January 2027 due to new federal work requirements, and hundreds of lawfully present immigrants will lose Medicaid eligibility regardless of work status. Connecticut has run surpluses averaging $1.8 billion annually since 2017, and Governor Lamont created a $550 million fund for one-time assistance but has not committed to ongoing state-funded replacements for federal programs. The state increased nonprofit provider funding by $60 million in fiscal year 2027, but advocates say payments still lag inflation by over $300 million annually.

Federal Policy·CT·17d ago

Four Connecticut Rural Hospitals Receive $46 Million in Federal Rural Health Grants

Charlotte Hungerford, Day Kimball, Sharon, and Windham Hospitals received $46 million in federal grants through the Rural Health Transformation Program to expand imaging, telehealth, and transport services. Day Kimball Hospital received the largest share at $20.2 million to replace trailer-based MRI services and expand patient monitoring. Connecticut received $154 million total under the program, with the remaining $104 million funding workforce development, maternity services, and mobile health initiatives across the state. CMS monitors fund deployment through annual progress reports that determine subsequent funding levels.

State Policy·CT·24d ago

Connecticut Report Finds 570,000 Households Below Survival Budget in 2024

United Way of Connecticut's annual ALICE report found 39% of state households — 570,000 total — could not afford a basic survival budget covering food, housing, utilities, childcare, healthcare, and transportation in 2024, down slightly from 2023 but still 14.5% higher than pre-pandemic levels. The survival budget threshold for a family of four remained $116,000. The report warns 2025 federal cuts to SNAP, Medicaid, and marketplace subsidies — including projected coverage losses for 110,000 Connecticut Medicaid adults by January 2026 — will likely worsen poverty metrics going forward. State lawmakers have not enacted a proposed child tax credit despite bipartisan support.

State Policy·CT·31d ago

Connecticut Lawmakers Threaten Subpoena Over Hospital's Gender Care Agreement with DOJ

Connecticut House Human Services Committee co-chairs Matt Lesser and Jillian Gilchrest are threatening to subpoena Connecticut Children's Medical Center to obtain details of the hospital's settlement with the U.S. Department of Justice regarding gender-affirming care for minors. The DOJ announced in August 2026 that Connecticut Children's agreed to stop providing gender-affirming care to minors, including hormones and puberty blockers, and pay a monetary penalty plus $500,000 in additional medical care. The lawmakers sent a letter requesting copies of the agreement and all correspondence between the hospital and DOJ, citing state law granting committee chairs subpoena power. Connecticut Children's agreed to meet with lawmakers next week and stated it did not turn over patient health information during the investigation or settlement process.

State Policy·CT·32d ago

Connecticut Economic Report Warns Rising Unemployment Threatens SNAP, Medicaid Work Requirements

Connecticut Voices for Children released its annual State of Working Connecticut report Monday, finding low- and middle-income families face rising unemployment (5.2% statewide, tied for highest nationally) amid slow economic growth. The report warns that higher unemployment creates immediate challenges as federal changes requiring 80 hours monthly work to maintain SNAP and Medicaid benefits take effect, with jobs becoming harder to find. Black workers and younger workers face unemployment rates well above the statewide average. The advocacy group recommends state-level programs to offset federal cuts and policy reforms including affordable housing, child care, expanded unemployment insurance, and indexing income taxes to inflation.

Industry·34d ago

Private Equity Healthcare Deal Volume Drops 50% in Physician Practice Management Amid State Oversight Laws

Private equity healthcare deals declined in both volume and value in the first half of 2026 compared to 2025, driven by new state oversight laws in at least 25 states. California, Oregon, and Rhode Island implemented transaction reporting requirements this year, while seven states enacted private equity guardrails in 2025. Physician practice management deals — the sector with the largest private equity presence — are on track to decline by half in 2026. The new state laws increase transaction costs, extend timelines, and restrict physician practice corporate ownership models that private equity has historically relied on for roll-up strategies.

Federal Policy·CT·34d ago

Connecticut Reports 63,000 Residents Lost SNAP Benefits Under Federal Budget Reconciliation Act

Connecticut Voices for Children reports that approximately 63,000 adults and children have lost Supplemental Nutrition Assistance Program benefits in the first year following passage of the federal budget reconciliation legislation known as the "One Big Beautiful Bill," significantly exceeding state officials' initial estimates. The losses stem primarily from new work requirements that affect individuals deemed unemployable due to mental illness or other disabling conditions. Connecticut responded with one-time $300 grocery cards to 25,000 residents and $24 million for food banks, but advocates say these measures address only a fraction of the need, with the state legislature not convening until January 2027.

Federal Policy·CT·45d ago

Connecticut Providers Prepare for 110K HUSKY Disenrollments Under Federal Eligibility Changes

Federal Medicaid eligibility changes take effect in January 2027 and could result in approximately 110,000 Connecticut residents losing HUSKY coverage. Connecticut health care providers, including hospitals and clinics, are actively preparing for the expected enrollment losses. The changes stem from federal legislation that modifies Medicaid eligibility criteria. Providers are most concerned about continuity of care disruptions and potential increases in uncompensated care as beneficiaries lose coverage.

State Policy·CT·60d ago

Connecticut Medicaid Considers Restricting HIV Medication Treatment Options

Connecticut's Medicaid program is considering implementing restrictions on HIV medication access that would limit available treatment options for beneficiaries. The proposed limitations would affect patients currently receiving or seeking HIV treatment through the state's Medicaid program. The timing and specific scope of the restrictions under consideration have not been publicly detailed. This development raises concerns about medication continuity and treatment adherence for Connecticut Medicaid beneficiaries living with HIV, particularly given clinical evidence supporting treatment choice in managing the condition.

Managed Care·CT·68d ago

Connecticut Hospitals Redesign Emergency Departments for Behavioral Health Crises

Hospitals in Connecticut are redesigning emergency rooms to better accommodate patients experiencing behavioral health crises. Physicians and hospital leaders report the specialized units create calmer, more therapeutic environments compared to traditional ERs. The redesigns address growing demand for mental health crisis services in emergency settings. The changes affect how Medicaid managed care organizations coordinate behavioral health emergency services and may influence network adequacy and crisis stabilization requirements.

Federal Policy·CT·90d ago

Connecticut Estimates Thousands Face Medicaid Loss Under New Federal Work Requirements

Connecticut officials project thousands of Medicaid beneficiaries could lose coverage when new federal work requirements take effect January 1, 2027. Congress and President Trump enacted the changes in an omnibus federal budget bill in July 2025. The requirements apply to able-bodied adults without dependents and mandate work, community service, or qualifying activities to maintain eligibility. Connecticut is preparing implementation plans and beneficiary outreach as the effective date approaches.

State Policy·CT·99d ago

Connecticut Medicaid Spending Rose in 2024 but Remained Lowest Per-Member Cost

Connecticut's Medicaid program experienced spending increases in 2024 while maintaining the lowest per-enrollee costs compared to commercial insurance markets in the state. The data shows Medicaid's cost efficiency persisted despite upward spending pressure. The comparison encompasses all insurance market segments operating in Connecticut. Medicaid managed care organizations in the state continue to deliver care at lower per-member costs than commercial carriers, though absolute spending grew year-over-year.

State Policy·CT·109d ago

Connecticut Faces Loss of 110,000 Adult Medicaid Enrollees

Connecticut anticipates approximately 110,000 low-income adults could lose Medicaid coverage, prompting state officials to develop strategies to prevent increased uninsured emergency department utilization. The coverage losses stem from ongoing Medicaid redeterminations following the end of continuous enrollment protections. State officials are working to transition affected enrollees to alternative coverage options and prevent gaps in care. The unwinding creates operational challenges for Connecticut managed care organizations managing member retention and care continuity.

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