Bipartisan CT bill adds healthcare consumer protections
Photo | CT Mirror
Senate leaders Martin Looney (D-New Haven, left) and Len Fasano (R-North Haven).
They may not agree on everything, but Sens. Martin Looney (D-New Haven) and Len Fasano (R-North Haven) took a bipartisan step this week toward passing what would be their third consumer-protection healthcare package since 2015.
The Senate on Tuesday voted nearly unanimously to pass an amended version of S.B. 42, which now contains a series of consumer protections that had been included in a smattering of other bills this session.
According to the two lawmakers’ remarks on the Senate floor Tuesday, some of the provisions in the bill, which now heads to the House with just seven days remaining in the regularly scheduled session, include:
- Adding laboratory services to the state’s definition of a “surprise bill,” which patients receive after not realizing certain providers who treated them were out of their coverage network.
- Banning gag clauses that forbid informing a patient in instances when it would be cheaper to pay out of pocket rather than through insurance.
- Changing the standard by which state courts review insurance contract disputes. Current state law instructs the courts to give some deference to insurance companies’ interpretation of their own contract language, which Looney called an “injustice” that’s been banned in a number of other states.
- Banning certain instances in which an insurer retrospectively denies coverage of emergency services, such as in the event that a patient thinks he or she is having a heart attack and goes to the emergency room, but later finds out it was some other condition, such as indigestion.
- Requiring hospitals to report to the Office of Health Strategy on their “trauma activation fees,” which are charged when a trauma team of surgeons and other providers are called in to treat a severely injured patient.
Some concepts in the bill are similar to those adopted in two prior laws championed by Repulican Senate Minority Leader Fasano and Democratic Senate President Pro Tem Looney.
The two senators previously worked together on Public Act 15-146, which placed restrictions on “facility fees” charged to patients by hospital-owned outpatient facilities and on surprise bills. It also created new reporting and approval requirements for the sale of physician groups.
Two years later, they helped shepherd Public Act 17-241, which banned gag clauses in pharmacy-benefit-manager contracts that prohibited pharmacists from informing patients when they could save money by simply paying cash rather than a co-pay.
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