Connecticut Senate Bill SB00329

Connecticut 2019 Regular Session

• Introduced: 1/23/19
• Refer: 1/23/19

Caption

An Act Concerning Health Insurance Coverage For Out-of-network Services Provided At In-network Hospitals.

Impact

The proposed changes to title 38a of the general statutes would substantially alter the financial dynamics of healthcare service delivery in Connecticut. By requiring that these services be treated as in-network, the bill has the potential to reduce the out-of-pocket costs for patients, making healthcare more affordable and predictable. Furthermore, it signifies a move towards greater protection for consumers who might otherwise be subjected to balance billing practices, which can result in significant financial distress.

Summary

SB00329 aims to address issues related to health insurance coverage by mandating that out-of-network services provided at in-network hospitals be covered at the same level as in-network services. The bill's primary focus is on ensuring that patients do not face unexpected high costs when receiving care from out-of-network providers in a facility that is part of their insurance network. This aligns with the growing concern over surprise medical bills that can arise when patients unknowingly receive treatment from out-of-network specialists during their hospital visits.

Contention

While the bill has the backing of many advocacy groups and healthcare consumers who are eager for increased protections and clearer billing practices, it could also raise debates among insurance companies and healthcare providers. Insurers may have concerns about the potential increase in costs associated with paying out-of-network providers at in-network rates. Additionally, healthcare facilities and out-of-network providers may dispute the terms of payment being imposed by the bill, leading to concerns over the sustainability of their revenue models in an evolving regulatory environment.