Bill Text: CT SB00289 | 2016 | General Assembly | Comm Sub
Bill Title: An Act Concerning Patient Notices, Designation Of A Health Information Technology Officer, Assets Purchased For The State-wide Health Information Exchange And Membership Of The State Health Information Technology Advisory Council.
Spectrum: Committee Bill
Status: (Passed) 2016-06-02 - Signed by the Governor [SB00289 Detail]
Download: Connecticut-2016-SB00289-Comm_Sub.html
General Assembly |
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February Session, 2016 |
*_____SB00289PH____032216____* |
AN ACT CONCERNING HEALTH CARE SERVICES.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Subsection (e) of section 38a-1084a of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(e) (1) On and after [January 1, 2017] sixty days after the report described in subsection (c) of this section is initially made available to the public on the Insurance Department's and Department of Public Health's Internet web sites, each hospital shall, at the time of scheduling a diagnosis or procedure for nonemergency care that is included in the report submitted to the exchange by the Insurance Commissioner and the Commissioner of Public Health pursuant to subsection (c) of this section, notify the patient of the patient's right to make a request for cost and quality information. Upon the request of a patient for a diagnosis or procedure included in such report, the hospital shall, not later than three business days after scheduling such diagnosis or procedure, provide written notice, electronically or by mail, to the patient who is the subject of the diagnosis or procedure concerning: (A) If the patient is uninsured, the amount to be charged for the diagnosis or procedure if all charges are paid in full without a public or private third party paying any portion of the charges, including the amount of any facility fee, or, if the hospital is not able to provide a specific amount due to an inability to predict the specific treatment or diagnostic code, the estimated maximum allowed amount or charge for the admission or procedure, including the amount of any facility fee; (B) the closest corresponding Medicare reimbursement amount; (C) if the patient is insured, the allowed amount, the toll-free telephone number and the Internet web site address of the patient's health carrier where the patient can obtain information concerning charges and out-of-pocket costs; (D) The Joint Commission's composite accountability rating and the Medicare hospital compare star rating for the hospital, as applicable; and (E) the Internet web site addresses for The Joint Commission and the Medicare hospital compare tool where the patient may obtain information concerning the hospital.
(2) If the patient is insured and the hospital is out-of-network under the patient's health insurance policy, such written notice shall include a statement that the diagnosis or procedure will likely be deemed out-of-network and that any out-of-network applicable rates under such policy may apply.
Sec. 2. Section 38a-477e of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(a) On and after July 1, 2016, each health carrier shall maintain an Internet web site and toll-free telephone number that enables consumers to request and obtain: (1) Information on in-network costs for inpatient admissions, health care procedures and services, including (A) the allowed amount for, at a minimum, admissions and procedures reported to the exchange pursuant to section 38a-1084a, as amended by this act, for each health care provider in the state; (B) the estimated out-of-pocket costs that a consumer would be responsible for paying for any such admission or procedure that is medically necessary, including any facility fee, coinsurance, copayment, deductible or other out-of-pocket expense; and (C) data or other information concerning (i) quality measures for the health care provider, (ii) patient satisfaction, to the extent such information is available, (iii) a list of in-network health care providers, (iv) whether a health care provider is accepting new patients, and (v) languages spoken by health care providers; and (2) information on out-of-network costs for inpatient admissions, health care procedures and services.
(b) A health carrier shall advise the consumer when providing the information on out-of-pocket costs that the amounts are estimates and that the consumer's actual cost may vary due to health care provider contractual changes, the need for unforeseen services that arise out of the proposed admission or procedure or other circumstances.
(c) The provisions of this section shall not apply to a health carrier with less than forty thousand covered lives for the health carrier in the state. If in any year, a health carrier exceeds forty thousand covered lives for the health carrier in the state, the provisions of this section shall begin to apply on January first in the following year.
This act shall take effect as follows and shall amend the following sections: | ||
Section 1 |
from passage |
38a-1084a(e) |
Sec. 2 |
from passage |
38a-477e |
Statement of Legislative Commissioners:
In two places in Section 2(c), "company" was changed to "health carrier" for internal consistency.
PH |
Joint Favorable Subst. |