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MedicaidReimbursementMedium impact

Nursing Facility Reimbursement Public Notice

Connecticut Medicaid (HUSKY Health)·CT · Geriatrics·Reimbursement
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Days to comply
11 days

Summary

Connecticut Department of Social Services is transitioning nursing facility Medicaid reimbursement to a Patient-Driven Payment Model (PDPM) and implementing a Medicaid Utilization Pool effective July 1, 2026. This change affects how nursing facilities are reimbursed for Medicaid patients.

Action Required

Before Jul 1, 2026
By July 1, 2026: Nursing facility billing teams in Connecticut must review the detailed SPA 26-0021 documentation at https://portal.ct.gov/DSS/Health-And-Home-Care/Medicaid-State-Plan-Amendments to understand the new Patient-Driven Payment Model requirements. Update billing processes and software to comply with the new reimbursement methodology for Connecticut Medicaid nursing facility claims.