Increasing Medicaid Reimbursement Rates

January 28, 2025

 

 

A recent state Medicaid Rate Study found that Connecticut lags well behind peer states when paying providers under Connecticut’s Medicaid program. Many areas of care are currently reimbursed at the same levels they were in 2007.

The multi-year plan to implement recommendations of the study includes:

  • Increasing reimbursement rates, up to current federal rate levels under Medicare, for all providers
    • Many providers are still reimbursed using the 2007 fee schedule: dental, school-based health centers, family planning, psychology and other services are all reimbursed based on 2007 rates
  • Bringing all providers up to at least a 75-80% reimbursement benchmark
  • Filling in the gaps 
    • Certain provider groups were excluded from the study, including home and behavioral health, dental, autism, naturopathy and others. The goal would be to increase reimbursements to a comparable level as peer states
  • Increasing formula grants under Medicaid to providers not covered in the study, including: FQHCs, substance abuse treatment, hospice and home health

The proposal envisions a systemic approach to future rate increases to prevent another 18-year stagnation of Medicaid reimbursements.