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November 28, 2017

State leaders call for binding arbitration to address disrupted insurance contracts

HBJ File Photo

[This story has been updated with comment from Hartford HealthCare.]

Comptroller Kevin Lembo and Senate President Pro Tem Martin Looney are both proposing steps to permit outside arbitration in the event of protracted hospital-insurer contract disputes.

At an informational meeting and public hearing Tuesday morning, set up in the wake of the recent Hartford HealthCare-Anthem contract standoff, both Lembo and Looney offered written testimony calling for legislation to address future contract disputes that would allow for mediation and binding arbitration.

Lembo specifically seeks up to 60 days of mandatory mediation if a contract expires unresolved, followed by binding arbitration, and other terms.

Looney (D-New Haven), who said he has introduced similar legislation in the past but encountered resistance from the healthcare and insurance industries, wants to bar physicians from being considered “out of network” during contract negotiations. He would also allow either party to request binding arbitration.

Lembo administers the largest employer plan in the state – providing health care coverage to approximately 200,000 state and municipal employees, retirees and their dependents.

“This contract dispute was not a battle between good and evil, or David and Goliath,” Lembo stated. “It was a fight between two large and powerful corporations that showed little regard for patients who were caught in the middle and merely used as cannon fodder….”

One patient, Ariana Lewis of South Windsor, testified that she suffers from a chronic illness, and empathizes with an acquaintance whose surgery was disrupted by the HHC-Anthem contract dispute.

“This sort of issue cannot be allowed to happen again and providers need to be held to a strict timeline for resolution of contract issues,” she wrote.

Anthem and HHC reached a contract agreement in mid-November, a month and a half after the original contract had expired. In the interim, HHC patients who have Anthem insurance coverage were forced to pay higher, out-of-network rates for most care at a HHC facility.

Later in the meeting, Dr. James Cardon, Hartford HealthCare executive vice president and chief clinical integration officer, who played a role in the negotiations, apologized for the standoff and its affect on patients.

"Our contract dispute with Anthem disrupted many of those who rely on us, and for that we are sorry," Cardon said. "Our calling in healthcare is not to confuse patients, but to care for them. We never want to put the people we care for in the middle."

Despite the problems, the end-goal was always about "achieving a fair contract that allows us to be sustainable, provide care that’s higher quality, more accessible and more affordable," he said.

The forum also is expected to include testimony from Insurance Commissioner Katharine Wade, Health Care Advocate Ted Doolittle, HHC and Anthem, and their customers and the public.

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