CMO Corner: Lawrence Magras, MD, MBA, FHM, FAAPL

Understanding Medicaid Limited Benefit Programs

Medicaid is a state and federal program that provides medical assistance to low-income families and adults, as well as individuals who are blind or otherwise disabled. . . read more

The Connecticut Department of Social Services (DSS) provides Medicaid through:

  • HUSKY A for children, their parents or a relative caregiver, and pregnant individuals
  • HUSKY C for individuals ages 65 or older, and individuals ages 16 to 65 who are either blind or who are living with another disability
  • HUSKY D for low-income individuals ages 19 through 65 without dependent children, who do not qualify for HUSKY A, who do not receive Medicare, and who are not pregnant
  • Medicare Savings Program for low-income Medicare enrollees

In addition to the above programs, DSS provides Medicaid coverage through certain limited benefit programs that allow coverage for specific conditions or services. The current limited benefit programs are outlined below.

Tuberculosis (TB) Limited Benefit Program – Covered Services

  • Services provided by physicians, Advanced Practice Registered Nurses (APRNs), Certified Nurse Midwives (CNMs), and Physician Assistants (PAs); medical, rehabilitation, and dialysis clinics; independent labs; independent radiology facilities; local health departments; and outpatient hospitals related to a TB diagnosis
  • Respiratory therapy in a rehabilitation clinic
  • A select group of medications used in the treatment of TB
  • Home health services limited to nurse observation of individuals diagnosed with TB self-administering oral TB medication
  • Non-emergency medical transportation

Family Planning Limited Benefit Program – Covered Services

  • Services provided by physicians, APRNs, CNMs, ambulatory surgical centers, clinics, independent labs, and outpatient hospital services as part of, or as a follow-up to, a family planning visit
  • Comprehensive physical exams
  • Screening and treatment for sexually transmitted disease
  • Voluntary sterilization (in accordance with state and federal guidelines)
  • Contraceptive services and supplies
  • HPV vaccinations (male and female)
  • Family planning related surgical treatments
  • Pregnancy tests
  • A select group of medications relevant to family planning services
  • TRUVADA for PrEP® (pre-exposure prophylaxis)
  • Non-emergency medical transportation

COVID-19 Testing Group/Medicaid for the Uninsured – Covered Services

  • COVID-19 lab testing
  • Chest x-ray when related to the ordering of COVID-19 testing
  • Emergency department and office visits related to the ordering of COVID-19 testing
  • COVID-19 treatment services including specialized equipment therapies (including preventive therapies) and treatment of a condition that may seriously complicate treatment of COVID-19 for those presumed to have or have been diagnosed with COVID-19
  • COVID-19 vaccine administration

Additional information on limited benefit programs is available on the Benefit Grids page of the HUSKY Health provider website.

Providers may verify a patient’s Medicaid eligibility and benefit plan information through the Automated Eligibility Verification System (AEVS) available on the Connecticut Medical Assistance Program (CMAP) secure provider portal.

Improving Preventive Care with Provider Portal Gaps in Care Reports and Analytic Tools

Preventive care and screenings are suboptimal in America with about half of the population completing preventive services. . . read more

Primary care providers can attest to the difficulties for patients to overcome barriers to seeking preventive care, both internal (fear, misunderstanding) and external (access, transportation). Community Health Network of Connecticut, Inc.® (CHNCT) encourages providers to utilize its data reporting tools found in CareAnalyzer® and on the HUSKY Health secure provider web portal. Providers can access our CareAnalyzer® population health and data analytics software to target members for care coordination services, and assess members with high-risk conditions for early intervention and development of disease management programs. Gaps in care can be identified to support wellness programs such as child lead screening (by 2nd birthday), weight assessment/counseling for children 3-17 years of age (BMI, nutrition, and physical activity), pharmacy adherence for disease conditions based on claims data, and to determine utilization trends. The HUSKY Health secure provider web portal contains a variety of reports including gaps in care, hospital admissions and discharges, and emergency department (ED) utilization. There is notation in the reports that identifies members who are working with our care management team. To obtain access and learn how to use the reports and tools, please contact Jeff Wolansky, Quality Management Network Liaison at

Save the Date! Essentials of Behavioral Health in Primary Care Virtual Conference – October 16, 2021

Community Health Network of Connecticut, Inc.® (CHNCT), in partnership with the Connecticut Behavioral Health Partnership/Beacon Health Options, is hosting its 6th annual Essentials of Behavioral Health in Primary Care Conference. . . read more

This is an integrated behavioral health program intended to educate primary care providers (PCPs) in the early identification, accurate diagnosis, effective treatment, and appropriate referral of patients with psychiatric disorders. This conference is being offered to PCPs enrolled in the Connecticut Medical Assistance Program (CMAP) at no cost. We have worked to ensure a varied program for professional development and networking opportunities.

This year’s program will cover the following topics:

  • Treatment of Attention-deficit/Hyperactivity Disorder in Children and Adolescents
  • Treatment of Anxiety and Depression in Children
  • Pharmacologic Treatment of Tobacco, Alcohol, and Opioid Use Disorders
  • Treatment of Anxiety and Depression in Adults

CME credits will be awarded based on the extent of the provider’s participation in the activity.

Please visit the HUSKY Health website this summer for additional details and to register.

2021 Behavioral Health in Primary Care Project ECHO® (Extension for Community Healthcare Outcomes)

The Community Health Network of Connecticut, Inc.® (CHNCT) Project ECHO® program provides ongoing education to HUSKY Health program primary care providers (PCPs) on a range of behavioral health related topics. Sessions are held on the third Wednesday of every month from 12:00 p.m. - 1:00 p.m. . . read more

The ECHO modelTM links PCPs from multiple sites, the spokes, to a specialist team, the hub, to manage patients with complex medical needs during virtual clinic sessions. During the clinics, a brief didactic presentation is given, followed by PCPs from multiple sites presenting complex cases to the hub team. Hub specialists serve as mentors and colleagues by sharing their knowledge and experiences. ECHO clinics afford PCPs an opportunity to not only confer with specialists, but also interact with peers throughout Connecticut.

We hope you will join us at one of our upcoming sessions!

For more information, please visit the ECHO page on the HUSKY Health website.

Intensive Care Management (ICM) Referrals

ICM provides a wide range of care coordination services for members with multi-morbid conditions and social determinants of health needs. These services help to reduce missed appointments and unnecessary trips to the Emergency Department (ED), and improve member self-care between provider visits. . . read more

ICM nurses work directly with you and your patients to manage chronic and multi-morbid conditions through a person-centered plan of care. By meeting members “where they are,” ICM nurses provide focused care coordination, resulting in improved patient participation for better health. ICM nurses conduct a comprehensive assessment to determine barriers to care. Some barriers include: a lack of understanding of their condition, including its pathophysiology, effects of disease progression, why medication is important, how to take prescribed medications and their potential side-effects, the importance of regularly scheduled medical follow-up appointments, how to recognize symptoms requiring medical attention, when to call their provider, transportation, and unmet basic needs like housing or food insecurity which are impacting members’ abilities to focus on their health needs. Assessments conducted by our ICM staff occur over the phone, in-person at the member’s home, as well as other community settings like providers’ offices, shelters, and hospitals.

ICM has specialty programs to meet your patients’ unique needs including programs for individuals with asthma, diabetes, Sickle Cell Disease, heart failure, COPD, CAD, and a program for your pregnant, postpartum, and Neonatal Intensive Care Unit (NICU) patients. All ICM programs are focused on providing evidence-based coaching to increase your patients’ understanding of their condition, and a plan of care to improve their health outcomes.

To refer patients to ICM, call 1.800.440.5071, x2024.

You can also go to, click “Information for Providers,” “Reports & Resources,” “Provider Forms,” then “ICM Referral Form.” Fax a completed ICM Referral form to 1.866.361.7242.

Over-the-Counter Coverage Reminder

Did you know that certain over-the-counter (OTC) medications are covered by the HUSKY Health program with a valid prescription? As social determinants of health play a major role in health outcomes, economic barriers can pose a problem in obtaining OTC medications that may be crucial for improving the health status of HUSKY Health members. Lowering economic barriers has been shown to increase adherence, which is associated with improved clinical outcomes.1 As many of your HUSKY Health patients may require therapies that are available for purchase OTC, it is important to note that with a valid prescription, OTC treatments such as low-dose aspirin, artificial tears, various topical products including mosquito repellents, and select vitamins, are covered under their HUSKY Health benefits. A list of therapeutic categories that are part of the OTC expanded coverage for HUSKY Health is available here:

1 Neiman AB, Ruppar T, Ho M, et al. CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and Opportunities. MMWR Morb Mortal Wkly Rep 2017;66. DOI:

Getting HUSKY Health Members Back into Care

HUSKY Health Member Engagement Services provides the first line of service for members and providers for any questions they may have.

Member Engagement Services provides assistance with all of the following and more:

  • Educating callers on HUSKY Health benefits and answering questions on topics such as member eligibility
  • Locating CMAP-enrolled providers and offering appointment assistance to members seeking care
  • Referring callers to the Connecticut Dental Health Partnership, Connecticut Behavioral Health Partnership/Beacon Health Options, non-emergency medical transportation, pharmacies, and other program partners
  • Referring members to community resources for food assistance, utility assistance, shelter, and other non-medical needs

Call us at 1.800.440.5071, Monday through Friday, from 8:00 a.m. to 6:00 p.m.