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General Assembly Substitute Bill No. 896
January Session, 2019
AN ACT ESTABLISHING RATIONAL HOSPITAL PR ICING.
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 hospital 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
health care entities to lower the cost of care, and (C) financial 17
incentives to reduce hospital readmissions and preventable health 18
issues. 19 Substitute Bill No. 896
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This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Statement of Legislative Commissioners:
In section 1, "prospective payment system" was changed to "hospital
prospective payment system" for consistency with the defined term.
HS Joint Favorable Subst. -LCO