CT SB00378

Health carriers offering individual or group high deductible health plans that are also network plans must directly reimburse participating providers for covered benefits delivered to covered persons.

Direct reimbursement requirement applies only to plans providing coverage types specified in subdivisions (1), (2), (4), (6), (10), (11), and (12) of section 38a-469 of the general statutes.

Health carriers must reimburse participating providers according to the provider's negotiated fee schedule.

Health carriers are prohibited from withholding or offsetting provider payments due to uncollected or outstanding deductibles, coinsurance, or copayments owed by covered persons.

Effective January 1, 2019.