Publications

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• Attorney General Tong Announces False Claims Settlement with Optician Your Eyes of New Britain

  Attorney General Tong Announces False Claims Settlement with Optician Your Eyes of New Britain

• Attorney General Tong, DSS Commissioner Bremby Announce Joint Federal-State False Claims Act Settlement with Waterbury Social Worker

  Attorney General Tong, DSS Commissioner Bremby Announce Joint Federal-State False Claims Act Settlement with Waterbury Social Worker

• Attorney General Tong, DSS Commissioner Gifford Announce $200,000 Settlement and Suspension Agreement with East Hartford Behavioral Health Providers, Resolving False Claims Act Lawsuit

• Attorney General Tong, DSS Commissioner Gifford, Comptroller Lembo Announce False Claims Act Lawsuit Against Therapy Unlimited for Allegedly Submitting False Claims to Connecticut’s Medicaid and State Healthcare Programs

  Attorney General Tong, DSS Commissioner Gifford, Comptroller Lembo Announce False Claims Act Lawsuit Against Therapy Unlimited for Allegedly Submitting False Claims to Connecticut’s Medicaid and State Healthcare Programs

• Attorney General Tong, U.S. Attorney Durham, DSS Commissioner Gifford announce settlement with Connecticut Counseling Centers over Drug Testing Overpayments

• Bulk Ordering of Forms

  To order bulk quantities of DSS forms, please follow this link to our Forms Requisition Site.

• Certificate for Disclosure of Gross Wages, Salary or Commission Paid W-35

  Certificate for Disclosure of Gross Wages, Salary or Commission Paid

• CHCPE Request for Referral - Spanish W-1487S

  CHCPE Request for Referral - Spanish

• CHCPE Request for Referral W-1487

  CHCPE Request for Referral

• Children Health Insurance Program (CHIP) State Plan Amendment

  HUSKY B is Connecticut’s Children’s Health Insurance Program (CHIP, also known as Title XXI). HUSKY B provides a free or low cost health insurance program for children and youth up to age 19 for families who are not income eligible for HUSKY A.

• Client Supplement for Medical Information W-303

  Client Supplement for Medical Information.

• Client Supplement for Medical Information W-303S - Versión en Español

  Client Supplement for Medical Information - Versión en Español.

• Confidentiality and Non-disclosure Agreement for Contractor Employees W-1077C

  Confidentiality and Non-disclosure Agreement for Contractor Employees.

• Connecticut Enters Joint State-Federal False Claims Act Settlement with Waterford Behavioral Health Provider

  The state and federal governments have reached a joint settlement resolving allegations that a Waterford psychologist submitted false claims for behavioral health services she never provided to her Connecticut Medicaid patients, Attorney General George Jepsen and Connecticut Department of Social Services (DSS) Commissioner Roderick L. Bremby said today.

• Connecticut Plan for the Federal Low Income Home Energy Assistance Program for Federal Fiscal Year 2025