Connecticut Hospitals and Physicians Urge Lawmakers To Reject Proposed Caps on Out-of-Network Healthcare Payments

A coalition of healthcare providers, hospitals, physicians, and bipartisan lawmakers are urging legislators to reject a proposal to cap out-of-network payment for hospital inpatient and outpatient services.  The proposed policy would have a harmful impact on hospitals, physicians, and Connecticut’s healthcare system, jeopardizing the ability to maintain current levels of patient access to services, the coalition explained at a press conference held on Wednesday, May 7.

The proposal, contained in the Lamont administration’s initial proposed biennial budget released in February, would give more leverage to national health insurance companies over Connecticut’s local hospitals in commercial contract negotiations.  The proposal was not included in the Appropriations Committee budget released in April but advanced out of the committee in HB 6871, An Act Limiting Out-of-Network Health Care Costs.

This proposed out-of-network cap policy:

• Could lead to more than $700 million in reduced payments to hospitals, at a time when Connecticut hospitals continue to struggle with negative operating margins
• Will jeopardize a hospital’s ability to maintain current levels of access to services for patients and undermine efforts to rebuild and recover financially from challenges of recent years, including a global pandemic, surging inflation, and workforce crisis
• Unfairly favors insurance companies in payer/hospital negotiations
• Ignores the ongoing impact of Medicare and Medicaid underpayment and administrative costs imposed by commercial insurers
• Will have severe and lasting consequences for Connecticut’s physicians, patients, and overall healthcare landscape

Representatives and physicians from Middlesex Health, Nuvance Health, Stamford Health, Trinity Health Of New England, and Yale New Haven Health participated in the press conference, standing united with other Connecticut healthcare providers from across the state.  Deremius Williams, MPA, senior vice president of payer strategy and innovation for Yale New Haven Health, and Susan Martin, chief financial officer and vice president of finance for Middlesex Health, spoke at the event and highlighted the impact on hospitals and the patients they serve.

The organizations comprising the coalition opposing out-of-network caps include:

• The Connecticut Hospital Association (CHA)
• Connecticut State Society of Anesthesiologists
• Connecticut Association of Ambulatory Surgery Centers
• Connecticut College of Emergency Physicians
• Connecticut State Medical Society
• CT Society of Plastic Surgeons
• Hartford County Medical Association (HCMA)
• Fairfield County Medical Association (FCMA)
• Connecticut Society of Eye Physicians (Eye M.D.s)
• CT Dermatology & Dermatologic Surgery Society
• Connecticut Urology Society
• Connecticut Orthopaedic Society
• Connecticut Chapter, American College of Physicians
• Connecticut Chapter, American College of Surgeons
• CT Association of Physicians of Pakistani descent of North America
• CT ENT Society
• CT Academy of Family Physicians
• Eastern Connecticut Medical Association
• American College of Obstetrician Gynecologists-Connecticut (ACOG CT)
• Radiological Society of Connecticut

Click here to read the coalition’s joint press release, which features remarks from several lawmakers and healthcare providers.

Read the coalition letter detailing these concerns here.

Watch the press conference here.