A:        No, this function is done by the Department of Public Health.  Their website is www.state.ct.us/dph.

Q:        What types of data does OHCA collect? {Closeup of Bar Graph}

A:       OHCA collects hospital utilization data on all discharges from the acute care hospitals within Connecticut.  In addition, OHCA gathers, verifies, analyzes and reports on a wide range of hospital financial data including hospital expenses, revenues, uncompensated care volumes, Disproportionate Share, and other financial data as needed.

Q:        How can I obtain the data that OHCA collects?

A:        Frequently Asked Questions About Hospital Inpatient Discharge Data page for all hospital discharge data requests. All other data requests, please refer to the Freedom of Information page.

Q:        How many acute care hospitals are there in Connecticut?

A:        There are 31 acute care hospitals in the state of Connecticut. 

Q:        What is the average length of stay in Connecticut in 2003 and how does that compare with the average length of stay nationally?

A:       The average length of stay in Connecticut for 2003 was 4.9 days. The 2003 average length of stay, the most recent available at this time, was 4.9 days as reported by the CDC.

Q:        What percentage of Connecticut residents were uninsured in 2004?  How was this determined?

A:        According to OHCA's 2004 Household Survey, the percentage of Connecticut residents in 2004 that did not have health insurance was 5.8 % or an estimated 196,000 people. 

Q:        What is a Certificate of Need?

A:        “Certificate of Need” (CON) is a process that authorizes a health care provider, or potential provider, to offer specified health related services, to purchase certain medical equipment, or to make capital expenditures over a specified dollar value – all within parameters defined by state law. For additional information please go to Certificate of Need section. 

Q:        When is a Certificate of Need necessary? {Nurses examing patient with electronic device}

A:        A Certificate of Need is necessary whenever a person, entity or health care facility intends to take some action described in Sections 19a-638 and 19a-639 of the Connecticut General Statutes.  These statutes describe activities which include the addition or termination of a health care service; the proposed capital expenditure of over one million dollars or the acquisition of major medical equipment costing in excess of four hundred thousand dollars; and the transfer of ownership, control, or governing powers of the board of the health care facility or its affiliates.  The statutes should be consulted for specific language.

Q:        When is a hearing held concerning a Certificate of Need proposal?

A:        OHCA may hold a public hearing with respect to the following:

1)   Use of technology that is new or being introduced to the State;

2)   New or additional health care function or service being introduced to

     the State; and

3)   Termination of any existing health care function or service, reduction

     of total beds or closing of health care facility.

4)  Effective October 1, 2005, under Public Act No. 05-75, OHCA shall hold a public hearing with respect to any complete CON application submitted to the office under this section if three individuals or an individual representing an entity with five or more people submit a request, in writing, that a public hearing be held on the proposal after the office has published notice of a complete letter of intent, and such request is received by the office no later than twenty-one calendar days after the office deems the CON Application complete.  

OHCA shall hold a pubic hearing with respect to any complete CON Application filed if the proposed total capital expenditure is $20 million or more for land, building or non-clinical equipment acquisition, new building construction or building renovation.  A waiver of hearing can be requested pursuant to OHCA Regulations Section 19a-643-45.

Q:        What was the average inpatient hospital charge in 2003?

A:        The average inpatient hospital charge in Connecticut was $15,992.  Hospital charges are the amount that a hospital bills a payer or patient. Since hospitals negotiate contracts with payers, a hospital charge is not always the same as the actual amount of reimbursement the hospitals receives from a payer.  The hospital charge also does not necessarily reflect the actual cost of care.

Q:        What are the Medicare and Medicaid programs?  

A:        Medicare is a federal program (established in 1965) to provide health
insurance coverage for people 65 and older as well as disabled persons,
regardless of financial status. Medicare consists of two separate but
coordinated programs: hospital insurance (Part A) and supplementary medical insurance (Part B).   Additional information can be found at www.medicare.gov.

          Medicaid is an entitlement program financed by both the state and federal
government (through the Social Security Administration) and managed by the states. Medicaid provides health care insurance to eligible persons younger than 65 years of age who cannot afford to pay private health insurance. The federal government matches the states' contribution on a certain minimal level of available coverage. Medicaid is found on the Department of Social Services website at www.dss.state.ct.us.
 

Q:        Who is the largest payer of health care in Connecticut?

A:        The largest payer categories of acute hospital costs are non government commercial payers which account for 48% of net revenues, followed by Medicare which accounts for 42% of net revenues.

Q:        How do I know if I have been billed correctly by my hospital?

A:        As a consumer of health services, you are entitled to an itemized copy of your hospital bill that details all of the services and supplies that you received.  The line-item bill should outline every service provided, the date it was provided, and should include item and procedure codes.

Q:        What if I find that I am unable to pay my hospital bills? {Couple discussing paperwork with woman}

A:        Many hospitals in Connecticut receive funds from the federal government and private donors to assist them in providing free or reduced cost care to needy patients.  Ask your hospital for information and assistance in applying for any such funds. 

Q:        With my existing health problems, where or how can I access affordable health insurance?

A:        If you are having trouble obtaining adequate health insurance, you may wish to contact the Health Reinsurance Association (HRA), a "high risk pool", at 1-800-842-0004.  This organization is mandated by the State of Connecticut to offer health insurance to any uninsured state resident nineteen years of age or older. 

Q:        My insurance company claims that the hospital’s charges are “above the usual and customary charges”.  Am I being overcharged by the hospital?

A:        Most fee-for-service health insurance plans base their reimbursement on a percentage of “usual and customary” charges, or on a percentage of the “prevailing rate” for services.  The information on which these charges and rates are based is not available to the public.  (However, each hospital’s rates are a matter of public record).  If your insurance company isn’t paying the submitted hospital charges because it claims that those charges are above the “usual and customary”, you may write the insurance carrier appealing for a higher reimbursement rate.  When making such an appeal to your insurance carrier, seek help and supporting documentation from the hospital and/or your health care provider.  

Q:        I am concerned about my physician’s fees and billing practices.  What recourse do I have?

A:        The State of Connecticut does not regulate private physician fees or billing practices.  If you are concerned about a billing problem, you must contact your physician directly.   However, if your concerns involved the quality of care your physician provided, you may contact:

State of Connecticut Department of Public Health
Division of Health Services Regulation
410 Capitol Avenue
MS #12HSR PO Box 340308
Hartford, CT  06134

You may also call at (860) 509–7400.

Q:        I am having problems with getting my HMO to pay my bill.  Do I have any recourse?

A:        The Office of the Managed Care Ombudsman helps Connecticut consumers who have health insurance provided by a managed care organization (MCO).   Their website is www.omc.state.ct.us.