On provider-insurer disputes, Connecticut residents spoke up and legislators listened

By Rosana Ferraro |

A little-discussed bill passed the House and Senate this past legislative session that promises to help out people caught between two big health industry forces – an insurance company on one hand, and a large hospital and provider system on the other.

Imagine – you pay your health insurance premium to Anthem every month, you get health care services from Hartford HealthCare – and then suddenly your health care provider is out of network because your insurer and your provider can’t agree on a contract.

What does this mean?  Should you cancel your appointment with your Hartford HealthCare physician?  Should you avoid the emergency room because the nearest hospital is owned by Hartford HealthCare?  Do you have your baby at a different hospital than originally planned?  What about that knee replacement surgery that took months to schedule?

This was the situation last fall, when Anthem & Hartford HealthCare failed to renew their contract with each other before their existing contract term expired.  Those affected were not happy – and they called their legislators about it.

Advocates, including the Foundation, spoke up about the impact on people.  The Insurance and Real Estate Committee of the legislature held a hearing on the issue last November, and several proposals for legislation were discussed.  In the end, Anthem and Hartford HealthCare agreed to a new contract, which also included covering services Anthem members received from Hartford HealthCare hospitals and providers during the dispute.

Despite the resolution, legislators were not deterred.  In this past legislative session, House Bill 5383 was introduced to require insurers and providers to abide by their old contracts for 60 days if they can’t agree on a new one.  This protects consumers from outrageous out of pocket costs for seeing their doctors or going to the hospital while health industry behemoths duke it out.

When the proposed bill got a public hearing, we made sure to speak up (read our testimony here), as did many others, including the Connecticut Office of the Healthcare Advocate.  You can check out all the testimony here.

So, what happened?

The bill passed the House and the Senate – the last step to put this bill into law is signature by the Governor.  We’ll keep you posted!

UPDATE 6/8/2018: The Governor signed the bill into law on June 6, 2018!