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General Assembly Raised Bill No. 896
January Session, 2019
LCO No. 4623
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT ESTABLISHING RATIONAL HOSPITAL PRICING.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective from passage) For purposes of this section, 1
(1) "all-payer hospital payment system" means a system in which 2
third-party payers, including, but not limited to, Medicare, Medicaid 3
and private insurers, pay the same rate for services, and (2) "hospital 4
prospective payment system" means a system in which Medicare pays 5
all hospitals a flat rate for services based on diagnostic groups and 6
other factors while other third-party payers may be charged more for 7
the same services. Notwithstanding section 17b-239 of the general 8
statutes, the Commissioner of Social Services shall seek approval from 9
the Centers for Medicare and Medicaid Services not later than 10
September 1, 2019, for a Medicare waiver exempting hospitals in the 11
state from the prospective payment system and allowing such 12
hospitals to be reimbursed for services under an all-payer hospital 13
payment system. The commissioner, to the extent permitted under 14
federal law, shall develop a waiver proposal that includes (A) a 15
hospital revenue cap, (B) incentives for hospitals to partner with other 16 Raised Bill No. 896
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healthcare entities to lower the cost of care, and (C) financial incentives 17
to reduce hospital readmissions and preventable health issues. 18
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Statement of Purpose:
To require the Commissioner of Social Services to seek a federal
Medicare waiver to change the way hospitals are reimbursed for their
services.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]