CT SB00876

Requires health carriers to reimburse out-of-network health care providers at the greatest of: the in-network rate, the usual and customary rate (80th percentile), or the Medicare reimbursement amount for services rendered at in-network facilities.

Limits patient cost-sharing for surprise bills (unexpected out-of-network bills) to the same copayment, coinsurance, deductible or out-of-pocket expense that would apply if services were rendered by an in-network provider.

Prohibits health care providers from billing patients or reporting to credit agencies for unpaid bills related to covered services, emergency services, or surprise bills when the health carrier is responsible for payment.

Makes it unlawful, unprofessional and immoral conduct for health care providers to request patient payment (beyond cost-sharing) for covered services, emergency services, or surprise bills, subject to disciplinary action by state licensing boards.

All provisions take effect July 1, 2017.