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Advocates push for biennial payment‑parity study after OHS report flags four insurers
Summary
Advocates and provider groups urged the Public Health Committee to create a biennial study of payment parity after an Office of Health Strategy report showed four large insurers met federal "warning signs" for parity noncompliance; they said underpayment shrinks in‑network capacity and shifts costs to state programs.
Advocates, clinicians and nonprofit providers urged the Public Health Committee to pass a bill requiring a biennial study of payment parity that would continue the Office of Health Strategy (OHS) work documenting differences in insurer payment for behavioral health versus medical services.
Christian Damiana of the Connecticut Parity Coalition summarized the OHS 2024 findings, saying the report showed four of seven major commercial insurers — Cigna Connecticut, Anthem, UnitedHealthcare and one other — met federal “warning signs” for parity noncompliance because they paid systematically lower rates for behavioral health services. Damiana and other witnesses said consistently lower behavioral‑health payments reduce the number of in‑network providers, lengthen wait times and push patients to out‑of‑network care or to state‑funded providers.
Speakers urged the committee to require continuing, structured analysis so the state can identify deficiency trends and hold insurers accountable. The Connecticut Community Nonprofit Alliance highlighted two concrete costs of underpayment: (1) an increased shift of patients from commercial insurance to Medicaid and (2) grant funds that the state must draw down to cover care when insurers deny claims, effectively transferring private costs onto state budgets.
Clinicians also described how low reimbursement and administrative burdens reduce provider participation in insurance networks, with consequences for workforce retention and patient access. Witnesses said the OHS analysis of all‑payer claims data exposed payment gaps and recommended follow‑up; a regular biennial study would create continuing public data to monitor changes and to guide enforcement or legislative responses.
Testimony also noted pending, complementary proposals to strengthen parity enforcement tools and urged coordination among the public health committee, OHS and the insurance department if the biennial study proceeds.
