CT SB00341

Reduces the time limit for health carriers to cancel, deny, or demand return of payment for authorized covered services from 18 months to 12 months after receiving a clean claim, effective January 1, 2027

Exceptions to the time limit remain for fraudulent claims, inappropriate billing, duplicate payments, claims paid by federal/state programs, or payments received from other insurers through coordination of benefits

Requires health carriers to provide at least 30 days' advance notice via certified mail, electronic mail, or facsimile before canceling, denying, or demanding return of payment

If a health carrier fails to respond to a provider's appeal within 15 business days, the appeal is automatically decided in favor of the provider

Providers have one year after receiving notice of cancellation or denial to identify and file claims with other applicable insurance coverage, regardless of that insurer's timely filing requirements