Connecticut's Democratic Gov. Ned Lamont on Tuesday issued an executive order that would only allow hospitals to bill uninsured patients for the Medicare price of their COVID-19 care.
HHS Secretary Alex Azar said April 3 that the federal government is considering using a provider emergency fund to pay hospitals back at Medicare rates for costs incurred treating uninsured patients. Lamont's order prohibits hospitals from billing uninsured COVID-19 patients until the governor issues further orders on how federal reimbursement funds will be distributed.
Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, said that Medicare rates would likely not be affordable for the uninsured unless the federal government steps in and ensures that uninsured COVID-19 patients will not be charged any cost-sharing.
The Connecticut Legislature banned surprise billing in 2016, and expanded the prohibition to apply to clinical labs last year. Payment for emergency and non-emergency surprise bills are handled differently in statute.
The executive order aligns payment for emergency and non-emergency out-of-network care by requiring insurers to pay providers in-network prices for care during the COVID-19 public health emergency. Emergency out-of-network procedures are otherwise reimbursed at the highest of the in-network rates, Medicare rates, or the FAIR Health 80th percentile charge benchmark.
The order also included a perk for providers: healthcare workers and facilities are immune from lawsuits if they are acting in good faith to provide COVID-19 care but face shortages or capacity issues.
The Connecticut Hospital Association praised the liability provision of Lamont's executive order.
"We are thankful for the appropriate liability relief that the most recent EO offers, as it acknowledges the extraordinary circumstances hospitals and clinicians are faced with while making decisions to treat and save patient lives," according to an association statement.