Connecticut Senate Bill SB00289

Connecticut 2026 Regular Session

• Introduced: 2/19/26
• Refer: 2/19/26
• Report Pass: 3/5/26
• Refer: 3/13/26
• Report Pass: 3/19/26
• Report Pass: 4/13/26
• Report Pass: 4/14/26

Caption

An Act Concerning Funding Of The Quality Metrics Program For Nursing Homes.

Summary

SB 289 makes several changes to Connecticut’s Medicaid nursing home payment system, centered on the state’s quality metrics program. It continues and expands the Department of Social Services’ authority to collect and report nursing home quality data, issue individualized annual reports to facilities, and use those metrics to shape Medicaid reimbursement. The bill also directs DSS to establish, within available appropriations, a quality metrics program that rewards high-performing nursing homes with enhanced Medicaid quality performance payments beginning in fiscal year 2029, funded by an annual $10 million pool. The bill further updates how nursing home Medicaid rates are calculated by requiring DSS to use the nursing component of the Patient Driven Payment Model for quarterly case-mix adjustments beginning July 1, 2026, and to rebase per diem rates using 2024 cost data. It also creates a Medicaid utilization pool for facilities with resident payor mixes that are more than 75% Medicaid, with $2.5 million available in FY 2027 and $5 million in later years. Facilities identified by CMS as special focus facilities, special focus candidates, or having an abuse icon are excluded from the quality metrics payment program.

Impact

The bill amends CGS section 17b-340d(a)(2) and affects how the Department of Social Services sets Medicaid reimbursement for nursing homes. It adds new payment mechanisms tied to quality performance, consumer satisfaction, CMS measures, and Medicaid utilization, while also requiring a phased-in shift to Patient Driven Payment Model-based rate calculations and a new rebasing of nursing home per diem rates. The practical effect is to redirect state Medicaid dollars toward facilities that score well on quality measures or serve a high share of Medicaid residents, subject to appropriations and prorating.

Sentiment

The available voting history suggests broad support for the bill. It received a unanimous 14-0 Joint Favorable Substitute vote in the Aging Committee and then passed the Appropriations Committee 44-6, indicating strong overall legislative approval with some reservations. No committee transcripts were provided, so the record does not show detailed debate, but the vote margins suggest the bill was generally viewed positively as a funding and reimbursement reform for nursing homes.

Contention

The main points of potential contention are the allocation and targeting of Medicaid funds, the use of performance-based payments, and the fiscal limits built into the bill. Nursing homes that do not perform well on quality metrics, or that are excluded because of CMS special focus or abuse designations, would not benefit from the new payment pool. There may also be concern about whether the $10 million quality pool and the utilization pool amounts are sufficient, and about the department’s discretion to weight measures, phase in rate changes, and prorate payments to stay within available appropriations.