MedicaidCoverageMedium impact
Policy Updates and Changes to Clinical Review Criteria
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, Pediatrics +9 more·Provider Bulletin
Effective date
May 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) is implementing new clinical review criteria and policy updates for various medical services and equipment effective May 1, 2026. This includes new policies for gene therapy drugs and updates to coverage criteria for medical equipment, devices, and specialized treatments.
Action Required
By May 1, 2026: Billing team must review updated clinical review criteria for affected services on the HUSKY Health portal (portal.ct.gov/husky). Contact Community Health Network of CT at 1-800-440-5071 for prior authorization questions. Ensure documentation meets new medical necessity criteria for services like medical equipment, gene therapies, and specialized devices to avoid claim denials.