Connecticut has a new law that will make health care prices more transparent, prevent “surprise billing,” limit facility fees, and restrict hospital consolidation thanks to the effort of NPA members in the state.
A rare opportunity for major health care reform emerged when the Democratic and Republican leaders of the state senate co-sponsored a series of bills to reshape health care in Connecticut. Both leaders expressed concern about the negative effects of hospital mergers on the cost of health care and the availability of essential services. A recent bid by Tenet—a for-profit hospital chain—to buy financially distressed hospitals in the state triggered the bipartisan effort by the senate leaders.
Hospitals quickly marshaled their forces to oppose the proposed legislation. NPA-CT joined with allies from labor, faith communities, patient safety and consumer advocacy groups under the leadership of the Universal Health Care Foundation of Connecticut to support the senate leadership.
An op–ed piece written by NPA-CT member Steve Smith appeared in the Sunday edition of the state’s largest and most influential newspaper, the Hartford Courant, urging bipartisan support for the bipartisan bill. NPA-CT members contacted their state representatives urging their votes in favor of the bill.
The efforts paid off with broad bipartisan support of the bill. The new law will enable consumers to go to an easy-to-understand website to obtain price and quality information on common health care services and procedures. Hospitals will be required to inform patients scheduled for non-emergency care about the cost of those services.
Patients will no longer be caught with “surprise bills” from out-of-network providers like the notorious $117,000 bill one patient received from an unknown, out-of-network assistant surgeon as reported in the New York Times. Patients will be held harmless for any costs from out-of-network providers unless they were informed about them ahead of time and chose to use them.
Hospitals will no longer be able to charge facility fees on top of professional fees for evaluation and management services in outpatient facilities off the hospital’s main campus. Facility fees may not exceed the Medicare facility fee for other services for uninsured patients.
The bill also strengthens the ability of the state to block hospital mergers even when both hospitals are not-for-profit if that merger would result in reduced services or higher prices. Mergers that are approved will be monitored by an independent reporter to assure that the merged entity delivers on its promises.
Finally, the new law charges the state’s health care cabinet to study models of health care in other states that could improve quality while reining in costs. NPA-CT hopes to participate in the process of shaping the future of health care in Connecticut.