What are the Office of Health Strategy’s responsibilities when it comes to facility fees?
The Office of Health Strategy’s (OHS) responsibilities are outlined in Conn. Gen. Statutes §19a-508c and include:
- Annually obtaining, posting and reviewing a sample billing statement from every hospital or health system in Connecticut that charges facility fees (Conn. Gen. Statutes § 19a-508c(d));
- Annually obtaining, posting and reviewing a sample of the prominently displayed written notice from every hospital-based facility in Connecticut that charges facility fees (Conn. Gen. Statutes § 19a-508c(h));
- Obtaining, posting and reviewing a copy of any written notice provided to patients when a group practice transaction results in the establishment of a hospital-based facility at which facility fees may be billed (Conn. Gen. Statutes § 19a-508c(k)(3));
- For each hospital-based facility that became hospital-based as a result of a group practice transaction in the prior calendar year, obtaining and reviewing reports of the number of patients served by such facility in the preceding three years (Conn. Gen. Statutes § 19a-508c(k)(5));
- Investigating and prosecuting violations of the facility fee statute (Conn. Gen. Statutes § 19a-508c) or any regulation adopted thereunder (Conn. Gen. Statutes § 19a-508c(l)(5)); and
- Annually obtaining and reviewing reports from each hospital and health system concerning facility fees charged or billed during the preceding calendar year (Conn. Gen. Statutes § 19a-508c(m)).
If you have reason to believe that a facility has violated one or more of the statutes referenced above, you should contact OHS at 860-418-7001 or OHS@CT.gov.
Additional resources:
The Office of the Healthcare Advocate (OHA) provides free assistance for Connecticut residents or members of insurance plans sited in Connecticut. OHA will assist with health plan selection, as well as direct advocacy with appeals of a healthcare plan's denial of a claim or service. If you've had a service denied and would like to appeal, or would simply like information about your rights and options, you can complete the Online Inquiry Form and they will contact you.