CT HB05377

Reduces the time limit for health organizations to cancel, deny, or demand return of payments for authorized services from 18 months to 15 months after receipt of a clean claim, effective January 1, 2027

Requires health organizations to provide at least 30 days' advance notice before demanding payment returns, and must include an electronic appeal process with a 12-business-day response deadline

Hospital-based facilities located off-site from a hospital campus must submit their own unique national provider identifier and federal tax identification number with each claim, separate from the main hospital campus, starting January 1, 2027

Health carriers are not required to reimburse claims from off-site hospital facilities that fail to include the required separate identifiers

Off-site hospital facilities that fail to comply with billing requirements cannot hold patients liable for payment of those claims