Connecticut 2022 Regular Session Status: In Committee 3 D cosponsors

SB 449 — AN ACT CONCERNING THE RECRUITMENT AND RETENTION OF PHYSICIANS IN THE STATE.

Last action — FILE NO. 434

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2022 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

159 added · 64 removed

159 line(s) added, 64 removed.

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General Assembly Raised Bill No.
Senate General Assembly File No.
449 February Session, 2022 LCO No.
434 February Session, 2022 Substitute Senate Bill No.
3389 Referred to Committee on PUBLIC HEALTH Introduced by:
449 Senate, April 12, 2022 The Committee on Public Health reported through SEN.
(PH) AN ACT CONCERNING THE RECRUITMENT AND RETENTION OF PHYSICIANS IN THE STATE.
DAUGHERTY ABRAMS of the 13th Dist., Chairperson of the Committee on the part of the Senate, that the substitute bill ought to pass.
AN ACT CONCERNING THE RECRUITMENT AND RETENTION OF PHYSICIANS IN THE STATE.
(c) Any physician who satisfies the eligibility requirements prescribed in subsection (b) of this section shall receive a grant for reimbursement of all federal and state educational loans in an amount LCO No.
sSB449 / File No.
3389 1 of 6 Raised Bill No.
434 1 sSB449 File No.
449 equal to twenty per cent of the balance of such loans per year for each year the physician is employed as a physician in the state.
434 (c) Any physician who satisfies the eligibility requirements prescribed in subsection (b) of this section and whose application made under subsection (d) of this section is accepted by the Office of Higher Educationshallreceiveagrantforreimbursementofallfederalandstate educational loans in an amount equal to twenty per cent of the balance of such loans per year for each year the physician is employed as a physician in the state.
Section 20-14p of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2022):
(Effective July 1, 2022) (a) On or before January 1, 2023, the CommissionerofPublicHealthshallconveneaworkinggrouptoadvise the commissioner regarding methods to enhance physician recruitment in the state.
(a) For purposes of this section:
The working group shall examine issues that include, but need not be limited to, (1) recruiting, retaining and compensating primary care, psychiatric and behavioral health care providers;
(1) "Covenant not to compete" means any provision of an employment or other contract or agreement that creates or establishes a professional relationship with a physician, including, but not limited to, a partnership or employment relationship, and restricts the right of a physician to practice medicine in any geographic area of the state for any period of time after the termination or cessation of such [partnership, employment or other] professional relationship;
(2) the potential effectiveness of student loan forgiveness;
(2) "physician" means an individual licensed to practice medicine under this chapter;
(3) barriers to recruiting and retaining physicians as a result of covenants not to compete, as defined in section 20-14p of the general statutes;
and (3) "primary site where such physician practices" means (A) the office, facility or location where a majority of the revenue derived from such physician's services is generated, or (B) any other office, facility or location where such physician practices and mutually agreed to by the parties and identified in the covenant not to compete.
(4) access to health care providers;
(b) (1) A covenant not to compete is valid and enforceable only if it is:
(5) the effect, if any, of the health insurance landscape on limiting health care access;
(A) Necessary to protect a legitimate business interest;
(6) barriers to physician participation in health care networks;
(B) reasonably limited in time, geographic scope and practice restrictions as necessary to protect such business interest;
and (7) assistance for graduate medical education training.
and (C) otherwise consistent with the law and public policy.
(b) The working group convened pursuant to subsection (a) of this section shall include, but need not be limited to, the following members:
The party seeking to enforce a covenant not to LCO No.
(1) A representative of a hospital association in the state;
3389 2 of 6 Raised Bill No.449 compete shall have the burden of proof in any proceeding.
(2) a representative of a medical society in the state;
(2) A covenant not to compete in an employment contract, other contract or agreement that is entered into, amended, extended or renewed on or after July 1, 2016, shall not:
(3) a physician licensed under chapter 370 of the general statutes with a small group practice;
(A) Restrict the physician's competitive activities (i) for a period of more than one year, and (ii) in a geographic region of more than fifteen miles from the primary site where suchphysician practices;or (B)beenforceable against aphysician if (i) such employment contract, other contract or agreement was not made in anticipation of, or as part of, a partnership or ownership agreement and such contract or agreement expires and is not renewed, unless, prior to such expiration, the [employer] party seeking to enforce the covenant not to compete makes a bona fide offer to renew the contract or agreement on the same or similar terms and conditions, or (ii) the employment [or contractual relationship] contract, other contract or agreement is terminated by the [employer] party seeking to enforce the covenant not to compete, unless such employment [or contractual relationship] contract, other contract or agreement is terminated for cause.
(4) sSB449 / File No.
(3) Each covenant not to compete in an employment contract, other contract or agreement entered into, amended or renewed on and after July 1, 2016, shall be separately and individually signed by the physician.
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(4) A covenant not to compete that is entered into, amended, extended or renewed on or after July 1, 2022, shall not be enforceable againstaphysicianiftheotherpartyto suchemploymentcontract,other contract or agreement that contains the covenant not to compete is a medical practice comprised of sixteen or more physicians.
434 a physician licensed under chapter 370 of the general statutes with a multisite group practice;
(c) The remaining provisions of any contract or agreement that includes a covenant not to compete that is rendered void and unenforceable, in whole or in part, under the provisions of this section shall remain in full force and effect, including provisions that require the payment of damages resulting from any injury suffered by reason of LCO No.
(5) one representative each of at least three differentschoolsofmedicine;
3389 3 of 6 Raised Bill No.449 termination of such contract or agreement.
(6)arepresentativeofa regionalphysician recruiter association;
Sec.
(7) the human resources director of at least one hospital in the state;
(8) a member of a patient advocacy group;
and (9) four members of the general public.
The working group shall elect chairpersons from among its members.
As used in this subsection, "small group practice" means a group practice comprised of less than eight full-time equivalent physicians and "multisite group practice" means a group practice comprised of over one hundred full-time equivalent physicians practicing throughout the state.
(c) On or before January 1, 2024, the working group shall report, in accordance with the provisions of section 11-4a of the general statutes, its findings to the commissioner and to the joint standing committee of the General Assembly having cognizance of matters relating to public health.
This act shall take effect as follows and shall amend the following sections:
Section 1 July 1, 2022 New section Sec.
2 July 1, 2022 New section Statement of Legislative Commissioners:
In Section 1(c), "and whose application made under subsection (d) of this section is accepted by the Office of Higher Education" was inserted before "shall receive" for clarity and consistency.
PH Joint Favorable Subst.
sSB449 / File No.
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434 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.
In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.
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Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
OFA Fiscal Note State Impact:
Agency Affected Fund-Effect FY 23 $ FY 24 $ Higher Ed., Off.
GF - Cost Significant Significant Higher Ed., Off.
GF - Cost 90,000 90,000 State Comptroller - Fringe GF - Cost 36,477 36,477 Benefits1 UConn Health Ctr.
Various - Savings Potential Potential Note:
Various=Various;
GF=General Fund Municipal Impact:
None Explanation The bill results in a significant cost to the Office of Higher Education (OHE) associated with the creation of a physician student loan reimbursement grant program, starting in FY 23.
Thebillestablishesastudentloanreimbursementprogram forpeople who are employed in-state as licensed physicians and meet various graduation and other requirements.
Eligible participants are to receive reimbursement grants of 20% of the physician’s federal and state student loan balance per year, for five years.
It is estimated that the median student loan burden, of a physician, upon graduation is approximately $161,000.
This would equate to a loan reimbursement award in the first year of up to $32,200.
If 50 eligible applicants were to receive such an award, the cost to OHE would exceed $1.6 million for The fringe benefit costs for most state employees are budgeted centrally in accounts administered by the Comptroller.
The estimated active employee fringe benefit cost associated with most personnel changes is 40.53% of payroll in FY 23.
sSB449 / File No.
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434 their first year of awards.
OHE does not currently have the funds available to operate this program.
The awards result in a significant cost to OHE;
the scope of the costs is dependent upon the number of approved applicants and their student loan balance reimbursements awarded annually.
OHE does not currently have the staff available to operate the program and would require one full-time program administrator, resulting in annual salary expenses of approximately $90,000 and corresponding fringe benefit costs of approximately $36,477.
The bill may have a positive fiscal impact to the University of Connecticut (UConn) Health Center, beginning FY 23.
It is possible that the loan reimbursement program will make Connecticut medical schools and job opportunities more attractive, compared to options in otherstates.
Inthe2020-21academicyear,substantialsharesofUConn's resident graduates and fellowship graduates left Connecticut to practice elsewhere.
To theextent thatthebillresultsinmore qualifiedapplicants for UConnHealth physicianvacancies,producing aquicker recruitment process for revenue-generating positions, then higher revenues may result.
The bill may also improve physician retention,resulting in lower recruitment expenses (a savings), but this impact is anticipated to be minimal because few UConn Health physicians have left for out-of-state positions in recent years.
The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to changes in physicians' student loan debt levels, the amount appropriated for the program, and the availability of similar programs in other states.
sSB449 / File No.
434 5 sSB449 File No.
434 OLR Bill Analysis sSB 449 AN ACT CONCERNING THE RECRUITMENT AND RETENTION OF PHYSICIANS IN THE STATE.
SUMMARY This bill requires the Office of Higher Education (OHE) to administer a physician student loan reimbursement grant program starting in FY 23.
OHE must do so in collaboration with the Department of Public Health (DPH) and within available appropriations.
The program must be open to state-licensed physicians employed here who (1) graduated from an in-state medical school or (2) completed their residency at a DPH-licensed hospital.
It must provide reimbursement grants of 20% of the physician’s federal and state student loan balance per year.
Under the bill, physicians may apply to OHE for grants in the time and manner the executive director prescribes and must only be reimbursed for loan payments made while they are employed as a physician in the state.
Any unspent funds appropriated for the program carry forward, rather than lapse, to the next fiscal year.
The bill also requires the DPH commissioner, by January 1, 2023, to convene a working group to advise her on ways to enhance physician recruitment in the state.
The group must report its findings to the commissioner and the Public Health Committee by January 1, 2024.
EFFECTIVE DATE:
July 1, 2022 PHYSICIAN RECRUITMENT WORKING GROUP Under the bill, the physician recruitment working group must examine at least the following issues:
sSB449 / File No.
434 6 sSB449 File No.
434 1.
recruiting, retaining, and compensating primary care, psychiatric, and behavioral health care providers;
2.
the potential effectiveness of student loan forgiveness;
(Effective July 1, 2022) From July 1, 2022, until June 30, 2025, the Department of Public Health shall waive the payment of the fees for a license renewal described in subsection (b) of section 19a-88 of the general statutes for each physician licensed under chapter 370 of the general statutes.
barriers to recruiting and retaining physicians due to non- compete clauses;
Sec.
(Effective from passage) (a) There is established a task force to study the ways in which medical malpractice policies and certain insurance industry practices result in an increased workload for physicians and limit a physician's ability to provide basic care to the physician's patients.
access to health care providers and any effect of the health insurance landscape on limiting health care access;
Such study shall include, but need not be limited to, an examination of opportunities for reforming such policies and practices, including, but not limited to, establishing homestead protections.
(b) The task force shall consist of the following members:
(1) Two appointed by the speaker of the House of Representatives;
(2) Two appointed by the president pro tempore of the Senate;
(3) One appointed by the majority leader of the House of Representatives;
(4) One appointed by the majority leader of the Senate;
(5) One appointed by the minority leader of the House of Representatives;
(6) One appointed by the minority leader of the Senate;
(7) The Insurance Commissioner, or the commissioner's designee;
and (8) The Commissioner of Public Health, or the commissioner's designee.
LCO No.
3389 4 of 6 Raised Bill No.449 (c) Any member of the task force appointed under subdivision (1), (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member of the General Assembly.
(d) All initial appointments to the task force shall be made not later thanthirty daysafter theeffective date ofthis section.Any vacancy shall be filled by the appointing authority.
(e)The speaker oftheHouse ofRepresentativesandthepresident pro tempore of the Senate shall select the chairpersons of the task force from among the members of the task force.
Such chairpersons shall schedule thefirst meeting ofthe task force, whichshall beheld not later thansixty days after the effective date of this section.
(f) The administrative staff of the joint standing committee of the General Assembly having cognizance of matters relating to insurance shall serve as administrative staff of the task force.
(g) Not later than January 1, 2023, the task force shall submit a report on its findings and recommendations to the joint standing committees of the General Assembly having cognizance of matters relating to insurance and public health, in accordance with the provisions of section 11-4a of the general statutes.
The task force shall terminate on thedatethatitsubmitssuchreportorJanuary1,2023,whicheverislater.
Sec.
(NEW) (Effective July 1, 2022) (a) Not later than January 1, 2023, the Commissioner of Public Health shall establish a Physician Recruitment grant program.
barriers to physicians participating in health care networks;
The program shall provide an incentive grant in the amount of twenty thousand dollars for physicians who relocate to this state and practice full-time as a physician in this state for not less than two years after relocating.
and 6.
The commissioner shall define the nature, description and systems designed for grant proposals.
assistance for graduate medical education training.
(b) The commissioner may adopt regulations, in accordance with the provisions of chapter 54 of the general statutes, to carry out the provisions of this section.
The group must include at least the following 14 members, as shown in Table 1 below.
LCO No.
Table 1:
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Physician Recruitment Working Group Required Membership One representative each from an-state hospital association, in-state medical society, and a regional physician recruiter association Two state-licensed physicians:
449 Sec.
• one from a small group practice (i.e., less than eight full-time equivalent physicians) • one from a multisite group practice (i.e., a group with over 100 full-time equivalent physicians practicing across the state) One representative each from at least three different medical schools The human resources director of at least one in-state hospital A member of a patient advocacy group Four public members The bill requires the group to elect chairpersons from among its members.
6.
COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 29 Nay 0 (03/25/2022) sSB449 / File No.
(Effective from passage) The Department of Public Health shall study, in consultation with medical schools and teaching hospitals affiliated with a medical school in the state, methods for supporting and increasing medical residency programs in the fields of internal medicine, family practice, pediatrics, psychiatry, obstetrics and gynecology and rural health care.
434 7
Not later than January 1, 2023, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a of the general statutes to the joint standing committee of the General Assembly having cognizance of matters relating to public health regarding the results of such study.
This act shall take effect as follows and shall amend the following sections:
Section 1 July 1, 2022 New section Sec.
2 July 1, 2022 20-14p Sec.
3 July 1, 2022 New section Sec.
4 from passage New section Sec.
5 July 1, 2022 New section from passage Sec.
6 New section Statement of Purpose:
To recruit and retain physicians in the state.
[Proposed deletions are enclosed in brackets.
Proposed additions are indicated by underline, except underlined.]e entire text of a bill or resolution or a section of a bill or resolution is new, it is not LCO No.
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Action History

  1. FILE NO. 434

  2. SENATE CALENDAR NUMBER 298

  3. FAV. RPT., TAB. FOR CAL., SEN.

  4. RPTD. OUT OF LCO

  5. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 04/11/22

  6. FILED WITH LCO

  7. Joint Favorable Substitute

  8. PUBLIC HEARING 0321

  9. REF. TO JOINT COMM. ON Public Health

Sponsors

Sponsorship breakdown

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4 sponsors · 0 co-sponsors · 183 not signed on

Sponsors (4)

Co-sponsors (0)

None.

Not signed on (183)

183 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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public-safety healthcare education
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Frequently asked questions

Who sponsors SB 449?
SB 449 is sponsored by Hampton, John K., Martin M. Looney (Democratic), Susan M. Johnson (Democratic), and Maria P. Horn (Democratic).
What is the current status of SB 449?
This bill died with 2022 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 449?
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