Bill > SB00341

This bill aims to shorten the timeframe for health carriers, which are insurance companies or similar organizations that provide health coverage, to cancel, deny, or demand the return of payments from healthcare providers for authorized services. Specifically, it reduces the period from eighteen months to twelve months after a "clean claim" (a claim submitted correctly the first time) is received, with exceptions for fraud, incorrect billing, duplicate payments, payments that should have been covered by government programs, or payments received from other insurers. The bill also mandates that health carriers provide at least thirty days' advance notice of any cancellation, denial, or demand for payment return, specifying the amount, claim, and reason. Furthermore, it establishes an electronic appeal process for providers, requiring carriers to respond to appeals within fifteen business days, with appeals automatically favoring the provider if no response is received. This change is set to take effect on January 1, 2027.

Business and Industry

Insurance and Real Estate Committee (Joint)

https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=SB00341&which_year=2026