Consolidations of hospitals measure passes Senate muster [JI]

May 26, 2015

Journal Inquirer

HARTFORD — The Senate has approved a bill that incorporates a number of proposals intended to address consolidation of the health care market.

The bill is based on a series of proposals from Senate President Pro Tem Martin M. Looney, D-New Haven, and Senate Minority Leader Leonard Fasano, R-North Haven, a number of which were incorporated in some fashion into the legislation.

The bill garnered a 30-5 vote on Thursday, and now awaits action in the House.

“This bill is not just a critically important bill, it is a time-sensitive, critically important bill,” Looney said, echoing the sentiment of other supporters that the General Assembly needs to address the consolidation of health care providers.

The bill would take a number of steps intended to encourage doctors to maintain private practices, a problem that Fasano said has left New Haven County with few to no specialists in a number of medical areas.

While that can be true of any industry when consolidation occurs, Sen. John A. Kissel, R-Enfield, said consumers have little recourse when it comes to health care because it is essential.

“It can’t be the wild, wild west, and I hear that, and I believe in free markets, but in some instances free markets don’t work,” he said. “In some instances advocates are advocating for free markets so big fish can gobble up little fish.”

The bill presented to the Senate on Thursday includes the following provisions:

  • The creation of an advisory commission to work with the Department of Social Services on the creation of an electronic network for all licensed practitioners to share medical records. Looney and Fasano originally proposed using bonding to fund the creation of a network.
  • Revamping the existing SustiNet board into a health care cabinet responsible for reviewing cost containment models, establishing growth benchmarks, analyzing data, and considering policy recommendations to help consumers. A prior bill created a new commission to do these things.
  • Expanding the state’s current certificate of need process for proposed hospital sales to include a cost and market impact analysis.
  • Creating a website that allows consumers to compare health plans and assigns ratings to those plans. It will be based on data submitted to the state.
  • Limiting surprise billings and the use of facility fees. Prior bills were more stringent, but Fasano said he, Looney, and other lawmakers involved in drafting this bill decided it would be difficult to implement the stricter limits.
  • Allow the Connecticut Health and Education Facilities Authority to examine ways to help community hospitals acquire financing.

All of the language was incorporated into a bill originally intended to simply address the state’s oversight of proposed hospital sales.

Looney and Fasano proposed nine bills on the issue of hospitals, but the remaining bills stalled in committees as lawmakers worked the language into one bill.

Looney said the compromises were the result of a series of discussions going back 18 months, and yet he’s heard from some lobbying on behalf of the hospitals that the public hadn’t had the chance to review Thursday’s bill.

He said such comments “to me reflects either a very poor memory or else absolute disingenuousness or a scurrilous effort to disguise what the true facts are.”

Other lawmakers said the bill addresses problems that are caused by both federal regulations and a changing economy, creating a climate in which hospitals can easily entice doctors to join their networks.

“If you don’t have a choice on your health care and you have one or two providers, we have done a disservice to the state of Connecticut,” he said.

But a handful of Senators — four Republicans and a Democrat — voted against the bill. Sens. Joseph Markley, R-Southington, and Tony Guglielmo, R-Stafford, said their opposition was due to the limited time they had to review the bill.

Senators saw the bill as currently written for the first time early in the day.

“This is a wide bill, affects everybody, it makes huge changes, so I just like the chance to sit down and digest it and make sure that I can understand it,” Guglielmo said.

He said the “bill itself has a lot of great points,” but he said he hadn’t had the chance prior to the vote to review it in-depth and determine if he had any objections or concerns.

Guglielmo added that he wanted the chance to talk with officials at the three hospitals in his district — Rockville General in Vernon, Johnson Memorial Medical Center in Stafford, and Day Kimball in Putnam — to get their opinions.

Markley additionally raised a concern about the legislature making changes to health care laws at the same time that hospitals are the subject of proposed acquisitions.