In one of the biggest legislative victories for Connecticut physicians this year, Gov. M. Jodi Rell has signed a bill that broadens the type of fee information that insurance companies must provide to health-care providers and makes it tougher for health insurers to change fee schedules.
Effective Jan. 1, 2010, physicians, surgeons, chiropractors, podiatrists, psychologists, and optometrists will have access, in an electronic format, to entire fee schedules for their specialties as well as payment policies.
Previously, insurers were only required to disclose fees associated with the top 50 services that a physician uses in his or her specialty.
The bill also makes it harder for insurance companies to change contracted fee schedules with their physician.
Under the new law contracting health care organizations can make fee schedule changes:
• Once a year if it gives providers at least 90 days’ advance notice
• At any time if it gives providers at least 30 days’ advance notice of any changes that are based on best practice protocols, or to be consistent with changes made in Medicare, state or federal law.
“This law is a benchmark for health insurance contract transparency, rigorous managed-care regulation and brand new standards for health insurance audits and medical-payment policies,” said James Rohack, president of the American Medical Association.
Physicians in Connecticut and across the country have long been fighting for more transparency from insurance companies on their reimbursement fees and schedules.
The law represents the latest victory for health-care providers in the state, said Ken Ferrucci, director of government relations at the Connecticut State Medical Society.
Ferrucci said the insurance industry opposed the legislation early on, but he called the final bill a “negotiated one.”
The law also prohibits a contracting health organization from canceling, denying, or demanding the return of full or partial payment for an authorized covered service due to administrative or eligibility error, more than 18 months after the date of the receipt of a clean claim. The only exception to that rule is if fraud was involved in a claim.
“Without this effort, physicians and patients would be locked into today’s situation, where insurers have been able to make changes at will to contracts and disclose only a minimum amount of information,” said William Handelman, president of the CSMS. “This law provides necessary protections for physicians and their patients.”
Auto Insurance Shift
The Hartford Financial Services Group, Inc. has begun offering AARP-branded auto insurance through independent agents, representing a shift in marketing strategy for the company which traditionally made that coverage available only through direct sales by phone, Internet or mail.
The decision to expand through the agent channel was based on strong customer feedback, pilot testing and new research revealing that the majority of the nearly 40 million AARP members prefer the advice and counsel of a local agent when making decisions about their auto insurance, the company said.
“For 25 years, the industry-leading AARP-branded auto insurance program from The Hartford has been extremely popular, growing to almost three million policies in force,” said Michael Concannon, senior vice president of The Hartford.
By the end of 2009, AARP-branded auto insurance will be available from The Hartford through select authorized local agents in as many as 20 states. Beginning July 18, specially authorized agents in Georgia, Ohio, Virginia, Colorado and New Mexico started selling the product.
The products will be available through local agents by the end of the year in Connecticut.
Last year, The Hartford successfully piloted the offering in Arizona, Tennessee, Minnesota and Illinois.
The AARP-branded insurance program is designed specifically for Baby Boomers and includes:
Lifetime continuation which assures that the customer’s insurance policy will not be dropped as long as a few simple requirements are met.
RecoverCare which helps customers pay for assistance with daily errands and responsibilities, like cooking, cleaning, shopping, dog walking, transportation and yard work if they are injured in an auto accident.
Standard 12-month rate protection — versus the traditional six month policies offered by most companies.
Greg Bordonaro is a Hartford Business Journal staff writer.
