New Law Eliminates
“3-day Rule,” Expands Health Benefits
for Children and Adolescents with Serious Mental or
Nervous Conditions
Hartford, CT – On Friday, July 25,
Governor M. Jodi Rell held a bill signing ceremony in
her Capitol office to celebrate a new law that expands
benefits payable under group health insurance policies
for children and adolescents seeking emergency care
for serious mental or nervous conditions. The ceremony
was attended by the bill’s chief co-sponsor, State
Senate Minority Leader John McKinney (R-Fairfield);
as well as Fairfield residents Lisa Gfeller and her
daughter Kathryn Laudadio, whose personal story inspired
the new law.
In the summer of 2007, then 16-year old Kathryn Laudadio
collapsed while running on a hot and humid day. She
was brought to the emergency room at Bridgeport Hospital
and diagnosed with an abnormal heart rhythm. When she
was revived, doctors learned that Kathryn had lost more
than 10 pounds in the three weeks leading up to her
collapse. They asked additional questions and insisted
that the young girl immediately begin a treatment program
for anorexia. The emergency room doctors wanted to hospitalize
Kathryn, but there were no psychiatric beds available.
Kathryn and her mother complied with the doctors’
orders and enrolled in a 28-day treatment program at the Renfrew Center of Philadelphia. It was during the
stay at Renfrew that Lisa Gfeller learned that her Anthem
Blue Cross and Blue Shield health care plan would not
cover $13,420 in medical treatment costs for her daughter,
because of a loophole in Connecticut state law known
as the “three day rule.”
The “three day rule” dictated that insurance
companies do not have to cover residential treatment
of mental illness for children and adolescents unless the treatment starts immediately after a hospitalization
of not less than three days. Since Kathryn was released
from Bridgeport Hospital the day after she arrived in
the emergency room, Anthem was not bound by law to cover
her treatment.
Ms. Gfeller, a clerk in the Assessor’s Office
in the Town of Fairfield, took her case through two
levels of insurance appeals with Anthem, then prevailed
in an external appeal through the Department of Insurance,
a state agency whose help is available to all Connecticut
residents. Unfortunately, Anthem contested the decision,
at which time Ms. Gfeller reached out to the press and
to her State Senator, John McKinney of Fairfield. McKinney
introduced a bill in February of 2008 to repeal the
“three day rule.”
“More often than not, the best legislative fixes
and ideas for new laws don’t come from lawyers
or legislators, they come directly from citizens who
recognize a problem and reach out to their elected officials
to find solutions,” said Senator McKinney. “The
three day rule was an unfair requirement with no basis
in medicine. No other state had such a law and many
insurers had already eliminated the requirement from
their insurance products.”
In May, Senator McKinney offered an amendment on the
floor of the State Senate to repeal the “three
day rule.” The amendment passed; the bill was
adopted unanimously by the Senate and the House; and
the Governor officially signed it into law on May 27.
“I am so grateful Lisa and Kathryn had the courage
to tell their story and work as hard as they did to
help change this law. I hope they serve as an example
for others to be more involved in the legislative process
when they recognize a problem that their legislators
can fix,” said Senator McKinney.
Governor Rell echoed Senator McKinney’s sentiments
during last Friday’s bill signing ceremony and
the new law will be effective January 1, 2009. In the
final analysis, Ms. Gfeller said she is more than satisfied
with the results of her quest and in addition to thanking
Senator McKinney, who she called her “hero,”
she recognized the Attorney General’s Office –
in particular, Assistant Attorney General Charles C.
Hulin, as well as the Office of the Health Care Advocate,
Kevin Lembo. Ms. Gfeller said, “The highlight
of our year was being so graciously invited to the Capitol
and having the opportunity to meet Governor Rell.”
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