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Democratic lawmakers rap state regulators over higher copayments

Associated Press
April 14, 2006

HARTFORD, Conn. -- Leading Democratic state lawmakers on Thursday criticized a nearly three-year old state insurance regulation in a renewed push to cap insurance copayments.

Senate President Pro Tem Donald Williams and other legislators criticized Insurance Commissioner Susan Cogswell for issuing the regulation, which they said forced many residents to pay more out of pocket for some medical procedures, such as MRIs.
"We don't believe the commissioner has the authority to move this way, at least in the rule-making process," Williams said.

Williams and other lawmakers on Thursday said they will push legislation that would limit copayments, deductibles and other out-of-pocket expenditures for advanced imaging services to $50 a visit and $400 a year for all imaging services combined.

Another possibility is to change the process by which the commissioner can write new rules, lawmakers said.

Debra Korta, a spokeswoman for the Insurance Department, said the rule is within state law.

"What we're trying to do is strike a reasonable balance between cost-sharing and affordability for as many as possible," she said.

Cogswell is currently on medical leave for treatment of a non-cancerous growth in her head.

The Sept. 5, 2003, bulletin issued by the Insurance Department capped copayments at 50 percent of a particular service. Cogswell said her order was consistent with state and federal law.

The change was based on applications by managed care organizations, discussions between the industry and the Insurance Department and "changing marketplace standards," Cogswell said.

Williams, D-Brooklyn, said legislators will meet soon with agency lawyers to discuss "where we think they should be coming from in a full-fledged rule-making process where at least there's an opportunity for consumer input."

"There's a whole regulatory world that escapes scrutiny unless a constituent brings it to your attention," he said.

Harry Hajedemos, a Meriden radiologist, said he brought the issue to state Sen. Joseph J. Crisco Jr., co-chairman of the legislature's Insurance and Real Estate Committee.

In addition to increases he has seen in copayments required of his patients, Hajedemos is an employer of 100 workers at offices in five towns in central Connecticut.

"Every year, insurance companies are throwing some new loop into the system," he said.

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