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General Assembly Raised Bill No. 1452
January Session, 2025
LCO No. 5741
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING HOSPITAL -AFFILIATED PHYSICIANS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective October 1, 2025) (a) As used in this section: 1
(1) "Attending physician" means a physician licensed pursuant to 2
chapter 370 of the general statutes who is selected by, or assigned to, the 3
patient and who has primary responsibility for the treatment and care 4
of the patient; 5
(2) "Hospital" means any short-term acute care general or children's 6
hospital licensed by the Department of Public Health, including the John 7
Dempsey Hospital of The University of Connecticut Health Center; and 8
(3) "Relative value unit" means the value assigned by the Centers for 9
Medicare and Medicaid Services to certain current procedural 10
terminology (CPT) codes and Health Care Procedure Coding System 11
(HCPCS) codes to represent the cost of providing a service and 12
comprised of physician work relative value unit, practice expense 13
relative value unit and malpractice relative value unit multiplied by 14
conversion factor and geographic practice cost indices adjustments. 15
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(b) No hospital shall assign an attending physician more than 16
eighteen patients during a twelve-hour shift unless the hospital 17
compensates such attending physician at (1) a rate equal to (A) one and 18
one-half times such attending physician's hourly rate, or (B) one and 19
one-half times an hourly rate based on such attending physician's 20
annual salary, as applicable, or (2) an amount equal to the payments 21
such hospital would receive under a relative value unit payment 22
methodology for the attending physician's treatment of patients during 23
such shift, whichever is greater. 24
Sec. 2. (NEW) (Effective October 1, 2025) (a) As used in this section: 25
(1) "Group practice" means seven or more full-time equivalent 26
physicians, legally organized in a partnership, professional corporation, 27
limited liability company formed to render professional services, 28
medical foundation, not-for-profit corporation, faculty practice plan or 29
other similar entity (A) in which each physician who is a member of the 30
group provides substantially the full range of services that the physician 31
routinely provides, including, but not limited to, medical care, 32
consultation, diagnosis or treatment, through the joint use of shared 33
office space, facilities, equipment or personnel; (B) for which 34
substantially all of the services of the physicians who are members of 35
the group are provided through the group and are billed in the name of 36
the group practice and amounts so received are treated as receipts of the 37
group; or (C) in which the overhead expenses of, and the income from, 38
the group are distributed in accordance with methods previously 39
determined by members of the group. An entity that otherwise meets 40
the definition of group practice under this section shall be considered a 41
group practice although the shareholders, partners or owners of the 42
group practice include single-physician professional corporations, 43
limited liability companies formed to render professional services or 44
other entities in which beneficial owners are individual physicians; 45
(2) "Health system" means: (A) A parent corporation of one or more 46
hospitals and any entity affiliated with such parent corporation through 47
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ownership, governance, membership or other means, or (B) a hospital 48
and any entity affiliated with such hospital through ownership, 49
governance, membership or other means; 50
(3) "Hospital" has the same meaning as provided in section 19a-490 51
of the general statutes; and 52
(4) "Staffing change" means an increase, reduction or reassignment of 53
a large group's workforce that is not a significant staffing change, as 54
defined in section 3 of this act. 55
(b) No health system shall make any staffing change to a group 56
practice without (1) consulting with and giving due consideration to the 57
physician members of such group practice, or (2) submitting such 58
staffing change for review to the Commissioner of Health Strategy, 59
pursuant to section 3 of this act, if applicable. If a health system makes 60
any such staffing change without consulting with and giving due 61
consideration to such physician members or receiving approval for such 62
staffing change from the Commissioner of Health Strategy pursuant to 63
section 3 of this act, the Commissioner of Public Health shall appoint an 64
independent monitor to oversee such group practice for a period of one 65
year starting on the date of such appointment. A monitor appointed 66
pursuant to the provisions of this section shall: (A) Evaluate the quality 67
of patient care at such group practice after the staffing change is 68
implemented and ensure that the quality of patient care is maintained; 69
(B) assess and address any challenges faced by patients due to the 70
staffing change; (C) monitor whether the staffing change has resulted in 71
any decrease in services provided by the group practice; and (D) assess 72
and address any difficulties or adverse impacts experienced by 73
displaced physicians or group practices, including, but not limited to, 74
difficulties relating to the professional, financial or personal well-being 75
of such physicians or group practices. 76
(c) If the commissioner appoints a monitor pursuant to the provisions 77
of this section, the health system that made the staffing change to the 78
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group practice without consulting with and giving due consideration to 79
the physician members of such group practice shall compensate such 80
monitor at a rate determined by the commissioner. 81
(d) No health system shall require a physician practicing in a group 82
practice to join another group practice without such physician's consent. 83
(e) The commissioner may adopt regulations, in accordance with the 84
provisions of chapter 54 of the general statutes, to implement the 85
provisions of this section. 86
Sec. 3. (NEW) (Effective October 1, 2025) (a) As used in this section: 87
(1) "Group practice" means seven or more full-time equivalent 88
physicians, legally organized in a partnership, professional corporation, 89
limited liability company formed to render professional services, 90
medical foundation, not-for-profit corporation, faculty practice plan or 91
other similar entity (A) in which each physician who is a member of the 92
group provides substantially the full range of services that the physician 93
routinely provides, including, but not limited to, medical care, 94
consultation, diagnosis or treatment, through the joint use of shared 95
office space, facilities, equipment or personnel; (B) for which 96
substantially all of the services of the physicians who are members of 97
the group are provided through the group and are billed in the name of 98
the group practice and amounts so received are treated as receipts of the 99
group; or (C) in which the overhead expenses of, and the income from, 100
the group are distributed in accordance with methods previously 101
determined by members of the group. An entity that otherwise meets 102
the definition of group practice under this section shall be considered a 103
group practice although the shareholders, partners or owners of the 104
group practice include single-physician professional corporations, 105
limited liability companies formed to render professional services or 106
other entities in which beneficial owners are individual physicians; 107
(2) "Health system" means: (A) A parent corporation of one or more 108
hospitals and any entity affiliated with such parent corporation through 109
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ownership, governance, membership or other means, or (B) a hospital 110
and any entity affiliated with such hospital through ownership, 111
governance, membership or other means; 112
(3) "Hospital" has the same meaning as provided in section 19a-490 113
of the general statutes; and 114
(4) "Significant staffing change" means an increase, reduction or 115
reassignment of fifty per cent or more of a large group's workforce. 116
(b) Not less than one hundred eighty days before implementing a 117
significant staffing change, a health system shall provide notice to the 118
(1) large group practice affected by such change by first class mail or 119
electronic mail, and (2) Commissioner of Health Strategy. 120
(c) On or before the date a health system provides notice to the 121
commissioner regarding a significant staffing change pursuant to 122
subsection (b) of this section, such health system shall submit, in a form 123
and manner prescribed by the commissioner, an application review and 124
approval or disapproval of such staffing change. When evaluating such 125
application, the commissioner shall consider: (1) The extent to which the 126
significant staffing change will affect patient care at the group practice 127
or otherwise present challenges for the patients of the group practice; 128
(2) whether the significant staffing change will result in any decrease in 129
the services provided by the group practice; and (3) any difficulties or 130
adverse impacts that physicians affected by the significant staffing 131
change will experience, including, but not limited to, difficulties relating 132
to the professional, financial or personal well-being of such physicians 133
or group practices. The commissioner shall issue a decision approving 134
or disapproving an application not later than one hundred eighty days 135
after the date the commissioner receives notice pursuant to subsection 136
(b) of this section. 137
(d) No health system shall implement a significant staffing change at 138
a group practice without receiving approval pursuant to the provisions 139
of this section. 140
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(e) The Commissioner of Health Strategy may adopt regulations, in 141
accordance with the provisions of chapter 54 of the general statutes, to 142
implement the provisions of this section. 143
Sec. 4. (NEW) (Effective October 1, 2025) On and after October 1, 2025, 144
no institution, as defined in section 19a-490 of the general statutes, shall 145
terminate a physician licensed pursuant to chapter 370 of the general 146
statutes, except for just cause, which shall be determined solely by the 147
performance or conduct of the particular physician. Any provision in a 148
physician employment contract entered into on and after October 1, 149
2025, that permits an employer to terminate a physician at will shall be 150
void. 151
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2025 New section
Sec. 2 October 1, 2025 New section
Sec. 3 October 1, 2025 New section
Sec. 4 October 1, 2025 New section
Statement of Purpose:
To establish various employment protections for hospital-affiliated
physicians.
[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.]