Office of Health Strategy Approves CT Proton Therapy Center, LLC CON
For Immediate Release
April 11, 2022
(HARTFORD, CT) –The Connecticut Office of Health Strategy (OHS) announced today that it has approved, with conditions, the Certificate of Need application to allow Harford HealthCare Corporation and Yale New Haven Health Services Corporation to establish proton therapy services through a newly established joint venture, Connecticut Proton Therapy Center, LLC (“CPTC”). The 25,000 square-foot Proton Therapy Center will be located at 932 Northrop Road, Wallingford, CT. As part of this project, CPTC will utilize proton therapy, a type of radiation therapy that uses a high energy beam of protons to treat many solid cancer tumors, including tumors of the brain and central nervous system, eye, gastrointestinal tract, head and neck, liver, lung, prostate, spine, and some breast tumors.
OHS applied the following conditions, among others, to ensure compliance with the CON statutes, control costs and guarantee equitable access to care:
- The CPTC will admit patients for those in need of proton therapy in Connecticut and from surrounding states regardless or system affiliation or referral source.
- The CPTC will seek approval by the Connecticut Department of Social Services(“DSS”) as a Medicaid provider prior to commencing the approved service and comply with all requirements of participation following approval. The CPTC will submit to OHS a list of commercial carriers with which it participates, as well as updated clinical policies or guidelines from these carriers that document coverage for the services authorized under this Settlement. The CPTC shall provide this information and documentation annually for five years.
- The CPTC will use its best efforts to obtain approval of payment from the payer for patients covered by Medicaid, Medicare, commercial or other coverage, and will work with patients to exhaust all levels of appeal if initially denied, prior to initiating the service, or if coverage is made available for a portion of the full course of treatment, prior to the continuation of treatment beyond the approved course.
- If coverage for a patient remains denied after the exhaustion of appeal rights, or if a patient elects to proceed or continue with PBT services while appeals are pending, the CPTC has agreed to follow certain processes and procedures that ensure that patients will be given all information necessary before either commencing or continuing treatment so that they are making educated decisions regarding the costs of treatment. This includes, but is not limited to, the CPTC providing information regarding estimated costs, applicable appeals processes, timelines, the specific consequences of a coverage denial, and eligibility for financial assistance.
- The CPTC will engage services of a third-party health equity expert or experts, with at least one being located in Connecticut, to ensure equity in access for individuals and develop tools to measure equity in access.
- The CPTC will submit an annual report to OHS, not later than January 31st of the year following the conclusion of each of the first five (5) fiscal years of operation, submit an annual report to OHS that includes, among other things, important information regarding utilization, access to and costs of treatment, insurance coverage, and CPTC revenue.
- No CPTC charges for self-pay patients shall exceed the Medicare allowed amounts, in any year.
- Blended average annual increases to CPTC negotiated rates for all services will not exceed 3% annually for a period of five (5) years following the commencement of operations.
Pursuant to multiple sections of the General Statutes, OHS leads the Health Systems Planning Unit that administers the Certificate of Need program—a regulatory responsibility to promote statewide health facility and service development and monitor the impact of provider acquisitions and consolidations on the communities they serve.
All documents related to this CON application can be found in the OHS CON portal under Docket #32239.
Contact: Tina (Kumar) Hyde
Manager of External Affairs, Connecticut Office of Health Strategy
Cell: (860) 969.7228