Lesser Leads Talks On Medical Transparency For Black Patients

Press release from CGA:

May 5, 2021

State Senator Matt Lesser (D-Middletown), Chair of the Insurance & Real Estate Committee, led debate over Senate Bill 1008, that unanimously passed, 36-0, on the Senate Floor. This bill, 'An Act Concerning Health Equity, The Coronavirus Pandemic, And Pulse Oximeters, would ensure all health care providers are informed as well as inform their patients of the possible inaccuracy of the usage of a pulse oximeter. Anyone who has been to the doctor has likely had a pulse oximeter clipped to their finger to measure blood oxygen levels. This legislation allows more transparency surrounding the device and the inaccurate information it could display toward Black patients.

“This is an important health equity bill directly resulting from the COVID-19 pandemic," said Sen. Lesser. "We’ve learned that pulse oximeters can give dangerously inaccurate readings to black and brown residents. Educating health providers and ensuring that residents are not denied health coverage because of inaccurate readings are small but important ways to ensure that we close the health equity gap.”

The coronavirus pandemic has caused an increase in the use of pulse oximeters but according to a recent report done by the New England Journal of Medicine, these devices may be less accurate in people with dark skin pigmentation. The FDA has been informing patients and health care providers that although pulse oximetry is useful for estimating blood oxygen levels, pulse oximeters have limitations and a risk of inaccuracy under certain circumstances that should be considered.

Under the study, the authors reported that Black patients had nearly three times the frequency of occult hypoxemia (low oxygen levels in the blood) as detected by blood gas measurements but not detected by pulse oximetry, when compared to white patients. This legislation voted on today, will mandate each health care provider, health carrier, pharmacist, pharmacy, and pharmacy benefits manager to be informed by the Insurance Commissioner that a pulse oximeter is more likely to produce an inaccurate blood oxygen level reading for a Black individual as opposed to a white individual. This legislation will also ensure that each person who receives a pulse oximeter is informed that the device is more likely to produce an inaccurate blood oxygen level reading for a Black individual as opposed to a white individual. If this is the case, and a person receives an inaccurate reading, they may be deprived of necessary medical care.

Doctors say the devices are still extremely useful for spotting declining health in all COVID-19 patients, including those with darker skin, before they become severely ill. When the device is wrong, the reading is likely to be off by only a few percentage points. What’s important is that all patients, particularly those with darker skin, pay attention to any downward trend in oxygen readings, rather than fixating on a particular number.

Senate Bill 1008 also requires that no insurer, health care center, or health insurance policy may deny coverage for an otherwise covered benefit if such denial is exclusively based on an insured's blood oxygen level as measured by a pulse oximeter.

This press release was produced by CGA. The views expressed here are the author's own.