COMMUNITY HEALTH NETWORK OF CONNECTICUT INC

IN 2024, CHNCT CONTINUED TO RECEIVE FUNDS DIRECTLY RELATED TO THIRD PARTY LIABILITY CLAIMS OVERPAYMENT RECOVERY AUDIT WORK CONDUCTED BY FIRST RECOVERY (FR). SINCE CHNCT ENTERED INTO THE AGREEMENT WITH CT DSS AS THE MEDICAID PROGRAM'S MEDICAL ADMINISTRATIVE SERVICES ORGANIZATION EFFECTIVE JANUARY 1, 2012, CHNCT IS NO LONGER AT RISK FOR MEDICAID CLAIMS PAYMENTS AND AUDIT RECOVERY RESULTS HAVE DECREASED CONSIDERABLY. HOWEVER, FR CONTINUES TO CONDUCT RECOVERY AUDIT WORK SOLELY ON CLAIMS PAID THAT HAD A MEDICAL SERVICE PROVIDED PRIOR TO 2012.

CONNECTICUT MEDICAID MEDICAL ADMINISTRATIVE SERVICES PROGRAM: THROUGH ITS MEDICAID MEDICAL ADMINISTRATIVE SERVICES PROGRAM, CHNCT PROVIDES MEDICAL ADMINISTRATIVE SERVICES TO OVER 940,000 UNDERSERVED AND VULNERABLE MEMBERS OF CONNECTICUT'S MEDICAID POPULATION WHO PARTICIPATE IN THE CONNECTICUT DEPARTMENT OF SOCIAL SERVICES' HUSKY HEALTH PROGRAM. THIS PROGRAM PROMOTES AND IMPROVES THE HEALTH OF MEMBERS OF CONNECTICUT'S MOST VULNERABLE AND UNDERSERVED POPULATIONS. THROUGH THIS PROGRAM, CHNCT PROVIDES A COMPREHENSIVE ARRAY OF SERVICES IN MANAGING CHRONIC CONDITIONS, PROMOTING WELL CARE/PREVENTION, PROVIDING DIRECT SUPPORT TO INDIVIDUALS AND FAMILIES AND PROVIDERS, AND INTEGRATING AND ANALYZING DATA FROM MULTIPLE SOURCES.KEY OBJECTIVES OF THIS PROGRAM INCLUDE:IMPROVING QUALITY OF CARE AND HEALTH CARE OUTCOME FOR INDIVIDUALS SERVED BY CONNECTICUT'S MEDICAID PROGRAM WHILE DRIVING DOWN THE COST OF CARE THROUGH BETTER MANAGEMENT OF SERVICE UTILIZATION;PROVIDING UNINTERRUPTED AND SEAMLESS SERVICES TO MEMBERS OF CONNECTICUT'S MEDICAID POPULATION AND THE NETWORK OF HEALTH CARE PROVIDERS WHO SERVE SUCH POPULATION; ANDDERIVING INTELLIGENCE FROM OUR COMPREHENSIVE REPOSITORY OF CLAIMS AND CLINICAL INFORMATION TO OPTIMALLY MANAGE MEDICAL EXPENSES AND UTILIZATION.CHNCT IS DEDICATED TO SERVING MEMBERS OF THIS VULNERABLE AND UNDERSERVED POPULATION WITH THEIR DESIRE TO IMPROVE HEALTH OUTCOMES, DEVELOP MEDICAL SELF-MANAGEMENT SKILLS AND IMPROVE MEDICATION MANAGEMENT.