Source: https://sourceonhealthcare.org/states/connecticut/
Timestamp: 2020-02-18 15:13:33
Document Index: 571965558

Matched Legal Cases: ['§ 19', '§ 1', '§ 1', '§ 10', '§ 17', '§ 17']

Connecticut - The Source on HealthCare Price and Competition
Connecticut is a state to watch on healthcare cost and competition. Connecticut Attorney General George Jepsen has been particularly active in the past years in promoting fairness and transparency in healthcare pricing, as well as in promoting greater enforcement of provider consolidation. The Connecticut Antitrust Act contains provisions under which (often in addition to federal statutes) the state or private persons may bring claims. In addition, Connecticut has a robust process for requiring and evaluating requests for certificates of need. The state’s Certificate of Need Program is detailed on the department of health’s website.
In 2018, Connecticut was active in introducing legislation aimed at controlling pharmaceutical costs. The legislature passed HB 5384, which requires pharmaceutical companies to disclose and explain prescription drug price hikes. Drug makers must justify any pharmaceutical price that jumps 20 percent or more during a calendar year, insurers must report large drug cost increases when filing rate requests, and PBMs must report how much they collect in rebates and how much they keep. Additionally, the state passed SB 197, which adds biological products to existing laws regarding substitution of generic drugs.
All Key IssuesHEALTHCARE MARKETS -Provider Network --Telehealth or Telemedicine --Scope of Practice --Network Adequacy --Tiered Network or Narrow Network -Competition --Antitrust Enforcement --Healthcare Consolidation --Certificate of Need (CON) --Price Manipulation --Trade Secret -Rate Regulation -ACA MarketplaceHEALTHCARE COSTS -Cost Containment --Shared Savings or Right to Shop --Prior Authorization --Utilization Review -Price Gouging -Cost-Sharing or Out-of-Pocket Costs -High Deductible Health Plan (HDHP) -Health Savings Account (HSA) or Health Reimbursement Account (HRA) -Benefit Design -Provider Payment --Value-Based Payment --Capitation --Shared Risk or Risk-Based Payment --Facility FeeHEALTHCARE SYSTEM REFORM -Single Payer or Multi-Payer -Public Option -Delivery Reform -Quality or Value-Based Reform -Accountable Care Organization (ACO) -Medicaid Reform or Medicaid Waiver -Affordable Care Act (ACA)PRICE AND QUALITY TRANSPARENCY -All-Payer Claims Database (APCD) -Gag Clause or Non-Disclosure Agreement -Surprise Billing or Balance Billing -Quality MeasurePHARMACEUTICALS -Drug Pricing -Drug Formulary -Pharmacy Benefit Manager (PBM) -Pharmacy Regulation -Biosimilar or Generic Competition --Generic Competition Block or Delay -Medicaid Pharmaceuticals -Drug Importation
All StatusEnactedInactive / Dead
Conn. Gen. Stat. § 19a-486a. Sale of nonprofit hospitals: Certificate of need determination letter. Hearing. Application for approval: Health Care Institutions – Connecticut
Requires Certificate of Need determination for sale of non-profit hospitals.
Conn. Gen. Stat. § 1-210. (Formerly § 1-19). Access to public records. Exempt records: Freedom of Information Act – Connecticut
Provides that trade secrets are exempt from the Freedom of Information Act.
Conn. Gen. Stat. § 10a-256. Hospital Insurance Fund. Exemption from certain provisions of chapter 368z: University of Connecticut Health Center Finance Corporation Act – Connecticut
Provides that corporations created under the University of Connecticut Health Center Finance Corporation Act is subject to certificate of need requirements under Chapter 368z.
Conn. Gen. Stat. § 17-241 – Connecticut
Beginning on October 2017, no contract entered into between a health care provider, or any agent or vendor retained by the health care provider to provide data or analytical services to evaluate and manage health …
Conn. Gen. Stat. § 17a-248g. Birthing-to-three funding. Fees for services. Insurance coverage. Regulations. Authority of advanced practice registered nurse to order services: Department of Developmental Services – Connecticut
Among other things, states that advanced practice registered nurse, working within the nurse’s scope of practice in collaboration with a physician licensed, is deemed sufficient to order all such services for children enrolled in the …
All Key IssuesHEALTHCARE MARKETS -Provider Network --Telehealth or Telemedicine --Scope of Practice --Network Adequacy --Tiered Network or Narrow Network -Competition --Antitrust Enforcement --Healthcare Consolidation --Certificate of Need (CON) --Price Manipulation --Trade Secret -Rate Regulation -ACA MarketplaceHEALTHCARE COSTS -Cost Containment --Shared Savings or Right to Shop --Prior Authorization --Utilization Review -Price Gouging -Cost-Sharing or Out-of-Pocket Costs -Benefit Design -Provider Payment --Value-Based Payment --Capitation --Shared Risk or Risk-Based Payment --Facility FeeHEALTHCARE SYSTEM REFORM -Single Payer or Multi-Payer -Delivery Reform -Quality or Value-Based Reform -Accountable Care Organization (ACO) -Medicaid Reform or Medicaid Waiver -Affordable Care Act (ACA)PRICE AND QUALITY TRANSPARENCY -All-Payer Claims Database (APCD) -Gag Clause or Non-Disclosure Agreement -Surprise Billing or Balance Billing -Quality MeasurePHARMACEUTICALS -Drug Pricing -Drug Formulary -Pharmacy Benefit Manager (PBM) -Pharmacy Regulation -Biosimilar or Generic Competition
All Key IssuesHEALTHCARE MARKETS -Competition --Antitrust Enforcement --Healthcare ConsolidationHEALTHCARE COSTSPHARMACEUTICALS --Generic Competition Block or Delay
United States et al. v. Anthem, Inc., and Cigna Corp. – California, Colorado, Connecticut, District of Columbia, Federal, Georgia, Iowa, Maine, Maryland, New Hampshire, New York, Tennessee, Virginia
District Court: District of Columbia Status: Decided
On April 28, 2017, the Second Circuit affirmed the District Court’s decision to block the proposed $54 billion merger between Anthem and Cigna, siding with …
Connecticut’s current legislative term runs from 1/9/2019 – 6/5/2019. Connecticut’s next legislative session will convene in 2020.
Connecticut enacts budgets on a two-year cycle, beginning July 1 of each odd-numbered year. Connecticut’s new Biennial Budget will take effect on July 1, 2017 and is valid through June 30, 2019. Connecticut has not enacted its 2018-2019 budget. To view Connecticut’s most recent 2018-2019 Budget proposal, click here.
Connecticut was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.
In June 2012, AG Jepsen, in coordination with the FTC, declined to challenge the proposed merger of Yale-New Haven Hospital and The Hospital of Saint Raphael. The enforcement entities apparently based their decision, in part, on St. Raphael’s precarious financial condition at the time of the deal.
In 2014, Connecticut AG George Jepsen was active in attempting to control rising healthcare costs by monitoring provider consolidation and increasing price transparency. In April, the Connecticut AGO issued a report on these issues. Most recently, in December 2014, the AG approved a provider joint venture between Waterbury Hospital and Vanguard (a subsidiary of Tenet), subjecting the proposed deal to several conditions.
On Feb. 25, 2016, Connecticut’s governor issued an executive order demanding a review of the state’s certificate of needs process, and suspending the approval of hospital mergers until January 2017.
Connecticut’s Dept of Insurance will take a major role in reviewing the proposed Anthem-Cigna merger, alongside the AG’s office there. Ins Commissioner Katherine Wade’s former ties to Cigna and her husband’s position in-house counsel position there have raised questions of bias.
Access Health CT: Connecticut’s APCD Website
Using states as living laboratories to solve surprise medical billing
How state groups are working to lower healthcare prices
Centene, WellCare get OK from 5 states for $17B merger