Connecticut
LLC
Website link to register:
https://portal.ct.gov/SOTS/Business-Services/Business-Services
Naming conventions
Cannot use “University,” “Insurance,” or “Bank” without approval.
Must include “LLC,” “L.L.C.,” or “Limited Liability Company.” For medical offices, “PLLC” or “Professional LLC” applies.
Licensing Requirements
All members must have valid medical licenses issued by the Connecticut Medical Examining Board.
Malpractice insurance required. Comply with state health codes for medical practices.
Required documentation for medical practices
Articles of Organization, Professional Licenses, Malpractice Insurance, Health & Safety Certificates
Filing Fee: $120
Annual/Biennial Fee: $80
Additional Notes: Annual report due March 31.
Medicaid
Program Name: HUSKY Health
Official Website: https://portal.ct.gov/dss/services/health-and-home-care
Legislation: No specific legislation addressing DPC; practices operate within existing healthcare laws.
Private Contracting
Permitted; DPC practices must ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No specific restrictions on DPC practices; adherence to state and federal regulations is required.
Medicaid Program
Husky Health Connecticut provides Medicaid and CHIP coverage to eligible residents.
Notification Requirements
Notification strongly recommended to avoid confusion.
Provider Enrollment Requirements
Providers must enroll with Husky Health to serve Medicaid beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS informational bulletins recommend clarity on private contracting rules.
Opportunities for Collaboration
Potential collaboration with state healthcare initiatives focused on primary care access.
State-Specific Notes
Potential collaboration opportunities exist with Husky Health managed care plans.
Dispensing Medication
Board of Pharmacy Official Link: https://portal.ct.gov/DPH/Practitioner-Licensing–Investigations/Pharmacist/Pharmacy
State Licensing
Physicians must register with the Connecticut Department of Consumer Protection for controlled substances.
Scope of Practice
Dispensing medications is allowed within the physician’s scope of practice; controlled substances have stricter rules.
Inventory Management
Accurate inventory logs must be maintained, particularly for controlled substances.
Record-Keeping
Records must be compliant with state and federal regulations and available for inspection.
Dispensing Standards
Labels must comply with state requirements, including patient name, dosage, and prescribing details.
Controlled Substances
Controlled substances require DEA registration and reporting to the Connecticut PDMP.
Billing and Reimbursement
Comply with state and federal billing guidelines to avoid anti-kickback violations.
Federal Compliance
Adhere to federal and state standards for dispensing medications.
State Pharmacy Laws
Special registration is required for dispensing controlled substances within Connecticut.
Patient Consent
Informed consent is required prior to dispensing any medication.
Insurance and Liability
Physicians must carry liability insurance that includes coverage for medication dispensing.
Training Requirements
Continuing education is encouraged for compliance with state laws on controlled substances.
Audits and Inspections
Inspections are conducted periodically by the Connecticut Department of Consumer Protection.