Insurance and Real Estate Committee
JOINT FAVORABLE REPORT
Bill No.: SB-1048
AN ACT CONCERNING REIMBURSEMENTS FOR CERTAIN COVERED
Title: HEALTH BENEFITS.
Vote Date: 3/22/2021
Vote Action: Joint Favorable
PH Date: 3/18/2021
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Insurance and Real Estate Committee
REASONS FOR BILL:
The bill will require certain health insurers, preferred provider networks and other entities to
include certain provisions in contracts with health care providers regarding reimbursement for
certain covered health benefits. The bill will set site-neutral payment policies to eliminate the
differences in costs of procedures at different facilities.
RESPONSE FROM ADMINISTRATION/AGENCY:
Ted Doolittle, Connecticut Healthcare Advocate, Office of the Healthcare Advocate: Mr.
Doolittle testified that OHA supports the intent of the bill, but warns legislators that the
specific language used could be leveraged by providers to increase prices. He states that the
goal is to make expensive sites more affordable, not to make affordable sites more
expensive.
NATURE AND SOURCES OF SUPPORT:
Senator Martin Looney: Senator Looney testified that the wide variation in pricing for the
same procedure at different sites is beyond rational explanation. SB 1048 will institute site
neutral payment policies for certain services to reduce this issue.
NATURE AND SOURCES OF OPPOSITION:
Hartford Healthcare: HHC testified that the differences in pricing between different sites is
due to the difference in costs of operating hospitals versus smaller, out-patient clinics. SB
1048 will limit the ability to negotiate rates and rather than reducing costs, it will simply shift
costs to a different service.
Connecticut Association of Health Plans: CAHP testified that SB 1048 will result in
increased rates for all facilities. They state that there may be valid reasons for the variation in
costs.
Connecticut State Medical Society: CSMS testified that they are concerned the language
in Section 1(B) of SB 1048 is not specific enough. They believe that the term provider is too
broad and that it is reasonable for more experienced, more highly-trained providers to charge
more than a less qualified provider who offers a similar service. CSMS is in support of
Section 1(A) of the bill.
Connecticut Hospital Association: CHA testified that the costs of operating hospitals are
higher than that of smaller medical offices and that procedures are priced accordingly. The
Medicare program recognizes this and hospital-based procedures are entitled to a higher
level of funding. CHA also proposes that DOI set rates because government-set rates
underfund critical hospital services.
Reported by: Mallory Ferrick Date: April 5, 2021
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