Protections From Civil Liability For Healthcare Providers And Financial Protections For Patients

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Governor Lamont's Executive Order No. 7U Protection of Public Health and Safety During COVID-19 Pandemic and Response.

United States Food, Drugs, Healthcare, Life Sciences

Liability for Healthcare Providers

On April 5, 2020, Governor Lamont issued an Executive Order that is in step with the provisions of the Federal Government in the Coronavirus Aid, Relief, and Economic Security Act (known as the "CARES Act") regarding protections for healthcare providers against civil liability. Under the CARES Act, healthcare professionals shall not be liable under Federal or State law for any harm caused by an act or omission during the public health emergency if the professional is providing health care services in response to the COVID-19 emergency as a volunteer, while acting within their license, certification or registration, and with the good faith belief that the individual being treated is in need of health care services. See, https://shipmangoodwin.com/webfiles/CARES%20Act%20Summary%20040120.pdf

Governor Lamont's Executive Order No. 7U provides protection to health care professionals and facilities beyond those who are acting as volunteers. Specifically, Executive Order No. 7U provides that health care professionals and facilities shall be immune from civil liability for injury or death for acts or omissions undertaken that, due to lack of resources during the pandemic, prevented the healthcare provider from providing care at a level or manner that would have otherwise been required without the pandemic.

The Executive Order does not extend to acts or omissions that constitute a crime, fraud, malice, gross negligence, willful misconduct, or would otherwise constitute a false claim under 31 U.S.C. §§ et seq. Health care professional means an individual who is licensed, registered, permitted, or certified to provide health care services and includes any retired professional with an inactive license, or volunteer approved by the State of Connecticut Department of Public Health ("DPH"). Facility means a licensed or state approved hospital, clinic, nursing home, field hospital or other facility designated by DPH. This immunity remains in effect from March 10, 2020 until the public health emergency is declared by the Governor to have ended.

Financial Protections for the Uninsured and People Covered by Insurance Who Receive Out-of-Network Health Care Services During the Public Health Emergency

Effective immediately, and for the duration of the public health emergency declared on March 10, 2020 until the Governor declares that the public health emergency has ended the following is true:

If emergency services are provided to an insured by an out-of-network provider, the insurer will receive the claim directly from the provider and shall reimburse the provider the amount that the health plan would pay for an in-network provider. The Executive Order also prohibits the insurer from agreeing to reimburse the out-of-network provider a higher level of reimbursement which could result in a higher cost-sharing by the insured, by suspending Connecticut General Statute Section 38a-477aa(b)(3)(B).
No hospital providing services to an uninsured can bill the patient or their estate more than the Medicare rate for the services as payment in full, by modifying Connecticut General Statute Section 19a-673(b). Thus, there can be no cost-sharing for the patient or his/her estate.
No hospital, health system or hospital-based facility can charge a facility fee to an uninsured patient for the treatment of COVID-19 that is more than the Medicare rate, by modifying Connecticut General Statutes Section 19a-508c(1) to include this limitation.
No hospital shall bill any individual not covered by a public or private health plan for treatment and management of COVID-19, until clarification from the Governor as to whether there will be any federal funding to cover such services.
Hospitals, health systems and hospital-based facilities must maintain fiscal records to identify services provided to uninsured patients for treatment and management of COVID-19 and make those records available for the purpose of claiming reimbursement.

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