Sec. 20-7f. Unfair billing practices. - Connecticut Statutes

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Statutes > Connecticut > Title20 > Chap369 > Sec20-7f

      Sec. 20-7f. Unfair billing practices. (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 this chapter, chapters 371 to 373, inclusive, chapters 375 to 383b, inclusive, chapters 384a to 384c, inclusive, or chapter 400j.

      (3) "Enrollee" means a person who has contracted for or who participates in a managed care plan for himself or his eligible dependents.

      (4) "Managed care organization" means an insurer, health care center, hospital or medical service corporation or other organization delivering, issuing for delivery, renewing or amending any individual or group health managed care plan in this state.

      (5) "Copayment or deductible" means the portion of a charge for services covered by a managed care plan that, under the plan's terms, it is the obligation of the enrollee to pay.

      (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 copayment or deductible, for medical services covered under a managed care plan.

      (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 medical services when a managed care organization has primary responsibility for payment of such services.

      (P.A. 98-163, S. 1.)

      History: (Revisor's note: In 2003 a reference in Subsec. (a)(2) to "chapters 370 to 373, ..." was changed editorially by the Revisors to "this chapter, chapters 371 to 373, ...").

State Codes and Statutes

Statutes > Connecticut > Title20 > Chap369 > Sec20-7f

      Sec. 20-7f. Unfair billing practices. (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 this chapter, chapters 371 to 373, inclusive, chapters 375 to 383b, inclusive, chapters 384a to 384c, inclusive, or chapter 400j.

      (3) "Enrollee" means a person who has contracted for or who participates in a managed care plan for himself or his eligible dependents.

      (4) "Managed care organization" means an insurer, health care center, hospital or medical service corporation or other organization delivering, issuing for delivery, renewing or amending any individual or group health managed care plan in this state.

      (5) "Copayment or deductible" means the portion of a charge for services covered by a managed care plan that, under the plan's terms, it is the obligation of the enrollee to pay.

      (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 copayment or deductible, for medical services covered under a managed care plan.

      (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 medical services when a managed care organization has primary responsibility for payment of such services.

      (P.A. 98-163, S. 1.)

      History: (Revisor's note: In 2003 a reference in Subsec. (a)(2) to "chapters 370 to 373, ..." was changed editorially by the Revisors to "this chapter, chapters 371 to 373, ...").

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State Codes and Statutes

Statutes > Connecticut > Title20 > Chap369 > Sec20-7f

      Sec. 20-7f. Unfair billing practices. (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 this chapter, chapters 371 to 373, inclusive, chapters 375 to 383b, inclusive, chapters 384a to 384c, inclusive, or chapter 400j.

      (3) "Enrollee" means a person who has contracted for or who participates in a managed care plan for himself or his eligible dependents.

      (4) "Managed care organization" means an insurer, health care center, hospital or medical service corporation or other organization delivering, issuing for delivery, renewing or amending any individual or group health managed care plan in this state.

      (5) "Copayment or deductible" means the portion of a charge for services covered by a managed care plan that, under the plan's terms, it is the obligation of the enrollee to pay.

      (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 copayment or deductible, for medical services covered under a managed care plan.

      (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 medical services when a managed care organization has primary responsibility for payment of such services.

      (P.A. 98-163, S. 1.)

      History: (Revisor's note: In 2003 a reference in Subsec. (a)(2) to "chapters 370 to 373, ..." was changed editorially by the Revisors to "this chapter, chapters 371 to 373, ...").