SB 806 Connecticut Senate · 2025 Regular Session

AN ACT EXPANDING MEDICAID COVERAGE FOR TREATMENT OF CERTAIN EMERGENCY MEDICAL CONDITIONS.

SB 806 expands Medicaid coverage to include specific emergency medical conditions, such as high-risk pregnancy, Type 1 diabetes emergencies in minors, severe hypertension, unstable seizures, and acute psychiatric treatment. It directly affects individuals with these qualifying conditions who previously might not have received emergency Medicaid coverage for outpatient care. The bill requires the state to create an online application system by July 2026 for advance eligibility for outpatient emergency treatment, replacing emergency room visits where possible. This change aligns with federal Medicaid rules and aims to improve access to timely care for these critical health issues.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Jan 2025

Committee Review

Floor Vote

Governor

Introduced Jan 21, 2025 Last action Apr 1, 2025

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What changed between versions

Proposed Bill → Committee Bill · 5 edits

MODERATE

The bill was renumbered from Proposed Bill No. 806 to Committee Bill No. 806 and assigned a new Legislative Committee Office number (LCO No. 4105). The act's title was slightly shortened by removing the word 'OUTPATIENT' from the description of Medicaid coverage expansion. The bill now includes a new Section 1 with detailed definitions of emergency medical conditions and specific examples of conditions covered, along with requirements for establishing an advance application system by July 1, 2026.

Scope change

The bill's scope was expanded to include specific examples of emergency medical conditions that qualify for Medicaid coverage, moving from a general statement about outpatient treatment to a more detailed list of covered conditions including high-risk pregnancy, diabetes, renal failure, fractures, hypertensive emergencies, seizure disorders, cancer treatment, ventilator dependency, and psychiatric treatment.

DEFINITION

Added formal definitions for 'emergency medical condition' and 'emergency Medicaid coverage' with specific criteria for what qualifies.

ELIGIBILITY

Added a detailed list of 11 specific emergency medical conditions that qualify for Medicaid coverage, including high-risk pregnancy, diabetes Type 1, diabetic emergencies, renal failure, skull/arm/neck/leg/spine/pelvis fractures, hypertensive emergencies, seizure disorders, cancer treatment, ventilator dependency, labor and delivery, and psychiatric treatment.

REQUIREMENT

Added requirement for the Commissioner of Social Services to establish an administrative advance application system for emergency Medicaid coverage by July 1, 2026, with online and form documentation.

TECHNICAL

Changed bill numbering from Proposed Bill to Committee Bill and updated LCO number from 1236 to 4105; removed 'OUTPATIENT' from the act title.

TIMELINE

Added specific effective date of July 1, 2025 for the new section and July 1, 2026 deadline for establishing the advance application system.

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Committee

Mar 14, 2025

Upper · Passed

Joint Favorable

upper

Mar 6, 2025

Committee

REF. TO JOINT COMM. ON Human Services

upper

Mar 5, 2025

Upper · Passed

DRAFTED BY COMMITTEE

upper

Jan 21, 2025

Committee

REF. TO JOINT COMM. ON Human Services

upper

0 primary · 0 co-sponsors

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