March 22, 2023
Governor Lamont Proposes Laws To Scale back Well being Care Prices

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Governor Lamont Proposes Laws To Scale back Well being Care Prices


02/21/2023

Governor Lamont Proposes Laws To Scale back Well being Care Prices

(HARTFORD, CT) – Governor Ned Lamont right this moment held a information convention in New Britain to introduced that he has submitted multi-pronged legislative proposals to the Common Meeting that concentrate on decreasing well being care prices for Connecticut residents, with a selected emphasis on enhancing competitors, eliminating pointless costs, decreasing rising costs, and growing affordability for residents and employers.

The laws is Home Invoice 6669, An Act Defending Sufferers and Prohibiting Pointless Well being Care Prices, and Senate Invoice 983, An Act Limiting Anticompetitive Well being Care Practices.

“Gallup just lately reported that record-high numbers of Individuals are pushing aside care resulting from prices,” Governor Lamont stated. “Roughly 38% of Individuals postpone care in 2022, the very best share Gallup has ever seen in its 22 years of polling. Two-thirds of private bankruptcies are associated to medical debt, the most typical reason behind chapter, and healthcare is consuming a bigger and bigger share of GDP, now greater than 18%. We merely can now not afford to not take motion. These payments I’m proposing deal with this complicated drawback from a number of angles, and I’m calling on all events – insurers, hospitals, docs, employers, and customers – to hitch with me in engaged on options for the folks of Connecticut.”

“Entry to inexpensive and high quality well being care is considered one of most vital points going through Connecticut households and companies at a time when prices are rising and insurance coverage covers lower than it used to,” Comptroller Sean Scanlon stated. “The combat for higher well being look after the folks of this state is considered one of my largest priorities as comptroller, and I’m proud to be working with Governor Lamont to go a ‘sufferers first’ well being care reform agenda that may decrease prices and guarantee everybody has entry to the care they deserve.”

“Whereas our state’s well being care system is excessive in high quality and ranks among the many finest nationwide, the rising prices stay a barrier for a lot too many individuals and leads to many individuals pushing aside care as a result of they will’t afford it,” Dr. Deidre Gifford, govt director of the Connecticut Workplace of Well being Technique, stated. “It’s clear that hospital inpatient, hospital outpatient, and retail pharmacy prices are the biggest contributors to the well being care affordability drawback. Well being system consolidation and lack of competitors can be contributing. These multi-pronged proposals deal with main price drivers in these areas and broaden on our persevering with efforts to comprise medical prices.”

“The price of well being care is a problem for almost everybody within the state, however it’s significantly acute for folks of shade,” Tiffany Donelson, president and CEO of the Connecticut Well being Basis and member of the Workplace of Well being Technique’s Healthcare Benchmark Initiative Steering Committee, stated. “Information from the Connecticut Healthcare Affordability Index present that folks of shade are particularly prone to have well being care prices which might be unaffordable – that’s, their well being care prices are too excessive to fulfill different fundamental wants with out going into debt. The implications of unaffordable well being care are clear and troubling: folks skipping medicine, avoiding care, and family budgets stretched to the breaking level to repay medical debt. We can’t obtain well being fairness except well being care is inexpensive. The causes of excessive well being care prices are complicated, however the want is easy – we should all work collectively to guarantee that everybody can afford to get the care they want once they want it.”

The laws:

  • Eliminates hospital facility charges charged at free-standing places of work and clinics.
  • Implements stronger regulatory enforcement instruments on the Connecticut Workplace of Well being Technique to guarantee compliance with certificates of want necessities and associated situations of approval, reminiscent of price controls, affected person entry, and detailed reporting. This may curb well being care prices by stopping duplicative providers in particular areas, whereas making certain availability and entry to vital providers in all elements of the state.
  • Commits Connecticut to becoming a member of a multistate bulk buying consortium to barter prescription drug reductions that all the state’s residents will be capable to entry via a reduction card at their pharmacy.
  • Requires the Connecticut Workplace of Well being Technique to yearly publish an inventory of pharmaceuticals which might be experiencing main worth spikes to tell customers and prescribers about which drug costs are going up and by how a lot.
  • Reins in aggressive advertising and marketing practices by pharmaceutical representatives to make sure prescribers get clear and correct details about the medication they prescribe and generic alternate options. Pharmaceutical representatives can be required to finish a coaching, register with the state, and disclose related details about drug prices and efficacy throughout totally different races and ethnicity, if recognized.
  • Strengthens protections to make sure that discounted pharmaceuticals bought via the federal 340B program profit the low-income customers and communities this system was designed to assist.
  • Prevents worth gouging when sufferers get care from a supplier who just isn’t of their community. Particularly, the governor is proposing to restrict out-of-network prices for inpatient and outpatient hospital providers to 100% of the Medicare charge for a similar service in the identical geographic space.
  • Outlaws using anti-competitive contracting practices which have been utilized by well being techniques to impede competitors and enhance costs. This may present well being insurers with further bargaining energy to make it simpler to barter inexpensive costs for customers. These embody:
    • Anti-tiering clauses: Requiring a well being plan to increase a most well-liked worth tier standing to all services or supplier in a well being system, even when sure suppliers don’t meet price or high quality requirements for that tier.
    • Anti-steering clauses: Prohibiting insurers from utilizing incentives to steer sufferers to greater worth suppliers.
    • All-or-nothing clauses: Requiring well being plans to just accept all suppliers in a healthcare system or none of them.
    • Gag clauses: Stopping events from disclosing related data, together with worth or phrases of an settlement to a 3rd get together.

Home Invoice 6669 has been referred to the Public Well being Committee, and Senate Invoice 983 has been referred to the Insurance coverage and Actual Property Committee.

Twitter: @GovNedLamont

Fb: Workplace of Governor Ned Lamont


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