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Social Services commissioner warns Medicaid budget exposed to federal changes; committee asked for granular provider‑rate plans and waiver work
Summary
Department of Social Services leaders told Appropriations members that the governor's proposal assumes continued federal matching in several large items and that a federal policy shift on the hospital provider tax or other FMAP changes could force difficult state choices. DSS said it will provide detailed provider‑rate code lists and a plan for a
Andrea Barton Reeves, commissioner of the Department of Social Services, told the Human Services Subcommittee that the department’s proposed budget depends in part on continued federal matching funds and could be significantly affected by federal policy changes.
Reeves said the administration’s budget includes a $140 million hospital supplemental payment and other federal match assumptions. When Senator Austin asked about national reporting that the federal administration had criticized the hospital provider tax, Reeves cautioned that, while the department had seen statements from federal officials, “at the moment, as we sit here, our FMAP, our federal match numbers, remain the same,” and that if federal match were lost the state would face “difficult decisions” to readjust supplemental payments or replace federal dollars.
Committee members pressed DSS for specifics on planned Medicaid provider‑rate increases described in the governor’s budget. Commissioner Reeves said the budget includes funding to increase some Medicaid provider rates (noting a $10.4 million appropriation in year 1 and $25 million in year 2 in the budget documents) and that DSS will provide a granular list of provider codes and the intended distribution of those rate increases at the working session. “What we're doing… is we are working through the specific codes in very much the same way we did” for prior behavioral‑health increases, Reeves said.
Reeves and staff also described plans to spend $1 million (year 1) to develop an 1115 waiver to fund interventions that address social determinants of health — including partnerships with hospitals and community organizations to support housing, food and other nonmedical services — and a separate effort to test care coordination approaches for people with complex chronic and behavioral health needs using an administrative services organization (ASO) model. Director Bill Halsey explained the planning money will support design of a care‑coordination program focused on chronic‑disease outcomes for older adults and people with disabilities.
DSS said it had posted a Connecticut Law Journal notice of intent to submit a state plan amendment to CMS to cover two oral, FDA‑approved weight‑loss medications (orlistat and phentermine) and that the department will continue to comply with federal requirements for coverage of obstructive sleep‑apnea treatment tied to cardiovascular risk. Senator Lesser asked DSS to provide documentation backing budgeted savings associated with proposed restrictions to other weight‑loss medications and the fiscal assumptions behind those savings.
Ending
DSS agreed to provide the committee, at a working session, a detailed breakdown of which provider codes would receive rate increases, the projected dollar allocation by provider type and the cost assumptions behind waiver development and care‑coordination pilots; commissioners also said they would supply evidence supporting projected savings related to weight‑loss medication coverage changes.
