SB 000813 – Connecticut

Status: Inactive / Dead
Year Introduced: 2015
Link: https://legiscan.com/CT/text/SB00813/id/1235191/Connecticut-2015-SB00813-Comm_Sub.html

CONSUMER HEALTH INFORMATION WEBSITE: the state exchange would be required to establish a consumer health information website containing information that compares the quality, price, and cost of health care services, including: (i) comparative price and cost information for the most common referrals or prescribed services; (ii) comparative quality information for which comparative price and cost information is provided; (iii) data concerning health care-associated infections and serious reportable events; (iv) definitions of common health insurance and medical terms; (v) a list of health care provider types; (vi) factors consumers should consider when choosing an insurance product or provider group; (vii) patient decision aids; (viii) a list of provider services accessible to people with disabilities; and (ix) descriptions of standard quality measures. The Insurance Commissioner and the Commissioner of Public Health would be required to, on an annual basis, report and make available on their websites: (i) the 100 most frequently provided inpatient admissions in the state; (ii) the 100 most frequently provided outpatient procedures performed in the state; (iii) the 25 most frequent surgical procured performed in he state; and (iv) the 25 most frequent imaging procedures performed in the state. These lists would also need to include bundled episodes of care. Once determined, each health carrier would be required, on an annual basis, (i) allowed amounts paid to each health care provider for each admission and procedure included in the report (above) and (ii) out-of-pocket costs for each admission and procedure. Additionally, each hospital and outpatient surgical facility would be required to, on an annual basis, report: (i) the amount to be charged to a patient for each admission ad procedure required in he report (above); (ii) the average negotiated settlement on the amount to be charged; (iii) the amount of Medicaid reimbursement for each admission or procedure; (iv) the amount of Medicare reimbursement for each admission or procedure; and (v) the five largest health carriers according to the previous year’s patient volume and the allowed amount for each admission or procedure. In addition, on and after October 1, 2015, no contract entered into, or renewed, between a health care provider and a health carrier shall contain a provision prohibiting disclosure of negotiated pricing information, including, but not limited to, pricing information relating to out-of-pocket expenses. Additionally, each health carrier would be required to develop and publish an Internet web site and institute the use of a mobile device application and toll-free telephone number to enable 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 (i) at a minimum, admissions and procedures reported to the Connecticut Health Insurance Exchange pursuant to section 2 of this act for each health care provider in the state, and (ii) prescribed drugs and durable medical equipment; (B) the estimated out-of-pocket cost that the consumer would be responsible for paying for any such admission or procedure that is medically necessary, including any facility fee, copayment, deductible, coinsurance or other expense; and (C) data or other information concerning (i) quality measures for the health care provider, as such measures are determined by the Commissioner of Public Health in accordance with subsection (g) of section 2 of this act, (ii) patient satisfaction, (iii) whether a health care provider is accepting new patients, (iv) credentials of health care providers, (v) languages spoken by health care providers, and (vi) network status of health care providers; and (2) information on out-of-network costs for inpatient admissions, health care procedures and services.

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