Insurer UnitedHealthcare and hospital system Hartford HealthCare (HHC) reached a last-minute agreement over a contract impacting thousands of Connecticut residents, a process that patients found to be deeply stressful.
Past 10 p.m. Monday, United and HHC were yet to sign a contract, which was due to expire at midnight. Patients waited to find out if they would lose in-network coverage Tuesday morning.
“Am I going to keep that appointment that I have? Am I going to have that surgery?” asked Kathleen Holt, Connecticut’s health care advocate. “Am I going to be able to look at my long-term care? What if I have an emergency?”
Holt said her office fielded calls from concerned United members in Connecticut about the ongoing dispute. Now that a deal has been reached, it’s still not clear what the terms of the agreement are.
“Everything's been behind closed doors. We don't know if it's going to help the price of health care,” Holt said. “We don't know what services are going to be like at Hartford HealthCare. This can happen again and again and again.”
And it is.
In just two weeks, patients at UConn Health insured by ConnectictiCare are set to go out of network if the two organizations fail to reach an agreement by April 15.
“At UConn Health, our priority is providing high-quality care to our patients and community. We want to inform you that we are in ongoing negotiations with ConnectiCare to secure a fair agreement that ensures continued access to care at UConn Health, which includes UConn John Dempsey Hospital and UConn Medical Group,” according to a statement from UConn Health.
Holt said her office has begun to receive calls from concerned UConn patients insured by ConnectiCare, owned by the $41 billion health care giant Molina.
Legislation to protect patients stalls as contract disputes ramp up
Holt said her office is working on legislation to minimize patient uncertainty when contract renewals come up between providers and insurers.
“If you're in an insurance contract, [the legislation would allow you to] stay in-network for the length of your insurance contract until you have an opportunity to enroll in a different plan,” she said.
“A lot of people don't have that opportunity if they're in the middle of an insurance year, to move to a different insurer. So that's what we're hoping, so that [patients] don't have to go through this angst.”
The bill remains in the planning stage, and has not yet been formally proposed or brought before a committee for a public hearing, she said.
Another legislative proposal, Senate Bill 454, would let patients retain access to existing doctors at the same price regardless of contract negotiations, but it is yet to pass out of the Insurance and Real Estate Committee. The bill would also retain the same network of physicians for patients during insurer and provider contract disputes.
State Sen. Dr. Saud Anwar, (D-South Windsor), co-chair of the Public Health Committee, said the system currently “does not protect the patients.”
During contract disputes, providers and insurers “are more focused on getting the best deal for each other,” he said.
As a new contract dispute between UConn Health and ConnectiCare looms, Anwar expressed frustration over the slow pace of legislative action to better protect patients during contract disputes.
"We are hoping that some level of this conversation would happen in some of the Senate priority bills,” he said, “but as of right now, we have not seen a public hearing on this topic to address and prevent some things like this to happen again."
“Can you imagine a patient who has cancer, who just had a surgery and needs a follow up surgery and a chemotherapy, and in the middle of that is informed that you can no longer see the surgeon who operated on you?”
“Now you have to find another oncology specialist and a radiation therapy specialist in the middle of your therapy, and you will miss time, and God forbid, your cancer can spread,” he said. “This is a life and death issue.”
