The annual report of our state Office of Healthcare Advocate (OHA) describes the importance of this office and what CT consumers could lose if the Governor is successful in eliminating it. The number of patients getting help from the office has grown every year reaching 2,143 last year. Those cases returned over $5 million to CT consumers from insurance companies due to OHA’s efforts. The most common problem OHA helps with is consumers being denied treatment or service. Cases highlighted in the report include a nurse needing a heart transplant, coverage of a lifesaving immunization for a child with complex health needs, and ensuring that a high school student with leukemia received the care he needed from the right hospital. Not only does OHA help individual consumers, the office has also been active in correcting public policies that are hostile to consumers such as creating a definition of medical necessity in state law, public program accountability, and prohibiting insurers from revoking coverage just when a consumer becomes ill.
CT’s Dept. of Insurance, with far more staff and resources than OHA, returned $3 million to CT consumers last year across the industry including auto, life, homeowner’s, accident and health insurance.