AN ACT CONCERNING MEDICAID RATE INCREASES, PLANNING AND SUSTAINABILITY.

HB 7191 requires phased increases to Medicaid provider rates in Connecticut, aiming to reach at least 75% of corresponding Medicare rates by June 30, 2028. It mandates annual rate adjustments after 2028 using Medicare rates, a five-state benchmark (Maine, MA, NJ, NY, OR), or the Medicare Economic Index. The bill directly affects Medicaid providers and federally qualified health centers (FQHCs), requiring them to file updated cost reports annually and adjust encounter rates based on service scope changes. It also consolidates fee schedules to align with Medicare rates where possible and ensures parity between pediatric and adult care rates. The changes take effect July 1, 2025, with full implementation by 2028.