CT HB06871

Out-of-network hospital costs for inpatient and outpatient services capped at 240% of Medicare reimbursement rates for health benefit plans entered into, renewed, or amended on or after January 1, 2027

Patients cannot be charged more than their plan's authorized cost-sharing amounts; total costs (plan payment plus patient cost-sharing) cannot exceed the 240% cap

Health carriers must pass savings from reduced provider payments to consumers and reflect these savings in annual rate filings

Exemptions apply to hospitals located in rural towns designated by the State Office of Rural Health and federally qualified health centers

Office of Health Strategy required to report biannually to the legislature beginning January 1, 2028 on provider cost trends and compliance; violations subject to civil penalties up to $1,000 and mandatory refunds