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Connecticut General Statutes Title 20. Professional and Occupational Licensing, Certification, Title Protection and Registration. Examining Boards § 20-7f. Unfair billing practices

Current as of January 01, 2025 | Updated by Findlaw Staff

(a) For purposes of this section:

(1) “Request payment” includes, but is not limited to, submitting a bill for services not actually owed or submitting for such services an invoice or other communication detailing the cost of the services that is not clearly marked with the phrase “This is not a bill”.

(2) “Health care provider” means a person licensed to provide health care services under chapters 370 to 373,  1 inclusive, chapters 375 to 383b,  2 inclusive, chapters 384a to 384c,  3 inclusive, or chapter 400j. 4

(3) “Enrollee” means a person who has contracted for or who participates in a health care plan for such enrollee or such enrollee's eligible dependents.

(4) “Coinsurance, copayment, deductible or other out-of-pocket expense” means the portion of a charge for services covered by a health care plan that, under the plan's terms, it is the obligation of the enrollee to pay.

(5) “Health care plan” has the same meaning as provided in subsection (a) of section 38a-477aa.

(6) “Health carrier” has the same meaning as provided in subsection (a) of section 38a-477aa.

(7) “Emergency services” has the same meaning as provided in subsection (a) of section 38a-477aa.

(b) It shall be an unfair trade practice in violation of chapter 735a for any health care provider to request payment from an enrollee, other than a coinsurance, copayment, deductible or other out-of-pocket expense, for (1) health care services or a facility fee, as defined in section 19a-508c, covered under a health care plan, (2) emergency services, or services rendered to an insured at an urgent crisis center, as defined in section 19a-179f, covered under a health care plan and rendered by an out-of-network health care provider, or (3) a surprise bill, as defined in section 38a-477aa.

(c) It shall be an unfair trade practice in violation of chapter 735a for any health care provider to report to a credit reporting agency an enrollee's failure to pay a bill for the services, facility fee or surprise bill as set forth in subsection (b) of this section, when a health carrier has primary responsibility for payment of such services, fees or bills.

1 C.G.S.A. §§ 20-8a et seq. to 20-34 et seq.
2 C.G.S.A. §§ 20-50 et seq. to 20-195m et seq.
3 C.G.S.A. §§ 20-206a et seq. to 20-206aa et seq.
4 C.G.S.A. § 20-570 et seq.
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Cite this article: FindLaw.com - Connecticut General Statutes Title 20. Professional and Occupational Licensing, Certification, Title Protection and Registration. Examining Boards § 20-7f. Unfair billing practices - last updated January 01, 2025 | https://codes.findlaw.com/ct/title-20-professional-and-occupational-licensing-certification-title-protection-and-registration-examining-boards/ct-gen-st-sect-20-7f/

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