Connecticut Senate Bill SB00819

Connecticut 2025 Regular Session

• Introduced: 1/21/25
• Refer: 1/21/25

Caption

An Act Requiring Site-neutral Reimbursements For Certain Covered Health Insurance Benefits.

Impact

By introducing site-neutral reimbursement, this bill is anticipated to promote competitive pricing in healthcare services and may potentially lower costs for patients. It is designed to provide equal financial treatment for similar services regardless of the setting, which supporters argue could lead to improved patient access to care and a more equitable healthcare system. Additionally, ensuring consistent reimbursement practices can help healthcare providers manage their financial operations more effectively.

Summary

SB00819, titled 'An Act Requiring Site-neutral Reimbursements For Certain Covered Health Insurance Benefits', aims to establish a framework for site-neutral reimbursements within the healthcare system. This bill mandates that health insurers provide reimbursements to healthcare providers that are uniform, regardless of the facility ownership where healthcare services are rendered. This means that reimbursement rates for procedures will not vary based on whether a service is performed in a hospital-owned facility or an independent practice.

Contention

However, the bill has attracted various points of contention. Opponents may argue that site-neutral reimbursements could undermine the financial viability of certain healthcare facilities, particularly smaller or independently owned practices that may rely on higher reimbursements from hospital outpatient departments. Critics express concern that this measure could lead to unintended consequences, including potential reductions in service offerings or availability, especially in rural or underserved areas.

Notable_points

Furthermore, the bill addresses specific categories of Current Procedural Terminology (CPT) codes, including evaluation and management codes, telehealth codes, and drug infusion codes. This specificity indicates a targeted approach towards areas of healthcare where reimbursements are often variable, potentially improving consistency across the healthcare reimbursement landscape.