Sec. 19a-662. (Formerly Sec. 19a-168j). Cost reduction plan requirement. Regulations. - Connecticut Statutes

      Sec. 19a-662. (Formerly Sec. 19a-168j). Cost reduction plan requirement. Regulations. Effective for fiscal year 1993 and subsequent fiscal years: (1) The office shall require a hospital which engages in inefficient or inappropriate provision of uncompensated care services to submit to the office a cost reduction plan. The Commissioner of Social Services may prospectively reduce the hospital's disproportionate share payments upon notification by the office that the hospital has failed to submit such a plan or to implement a cost reduction plan approved by the office. (2) The office shall adopt regulations on admitting, billing and collection procedures. Each hospital shall submit to the office its admission, billing and collection procedures and protocols for approval by the office. In the event that the office finds that these procedures and protocols are inadequate, the office may instruct that they be modified. If a hospital does not modify its procedures and protocols as soon as practicable upon being instructed to do so by the office, or is found by the office to be failing to follow its approved procedures and protocols, the Commissioner of Social Services may reduce the disproportionate share payments to the hospital until such deficiency is corrected. (3) Effective for fiscal year 1994 and subsequent fiscal years, the office shall not recognize and the Commissioner of Social Services shall not make payments for shortfalls due to unpaid costs associated with admissions which were denied through utilization review or denied due to the hospital's failure to comply with payers' utilization review or claims submission requirements. Nothing in subdivision (3) of this section shall limit the hospital's right to collect from any legally liable person or entity for any services rendered.

      (Nov. Sp. Sess. P.A. 91-2, S. 13, 27; P.A. 94-9, S. 10, 41; P.A. 95-257, S. 39, 58.)

      History: P.A. 94-9 made technical changes related to termination of the pool and changed commission to commissioner of social services re prospective reduction of payments, effective April 1, 1994; P.A. 95-257 replaced Commission on Hospitals and Health Care with Office of Health Care Access, effective July 1, 1995; Sec. 19a-168j transferred to Sec. 19a-662 in 1997.