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General Assembly Raised Bill No. 340
February Session, 2020
LCO No. 1595
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
AN ACT CONCERNING CO LLECTION EFFORTS BY HOSPITALS AND
COLLECTION AGENTS AG AINST UNINSURED AND UNDERI NSURED
PATIENTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-673 of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2020): 2
(a) As used in this section: 3
(1) "Collection agent" has the same meaning as provided in section 4
19a-509b. 5
[(1)] (2) "Cost of providing services" means a hospital's published 6
charges at the time of billing, multiplied by the hospital's most recent 7
relationship of costs to charges as taken from the hospital's most recently 8
available annual financial filing with the unit. 9
(3) "High deductible health plan" has the same meaning as provided 10
in Section 220(c)(2) or Section 223(c)(2) of the Internal Revenue Code of 11
1986, or any subsequent corresponding internal revenue code of the 12 Raised Bill No. 340
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United States, as amended from time to time. 13
[(2)] (4) "Hospital" [means an institution licensed by the Department 14
of Public Health as a short-term general hospital] has the same meaning 15
as provided in section 19a-490. 16
[(3)] (5) "Poverty income guidelines" means the poverty income 17
guidelines issued from time to time by the United States Department of 18
Health and Human Services. 19
(6) "Underinsured patient" means any person who is insured under a 20
high deductible health plan and liable for one or more hospital charges, 21
and whose income is at or below six hundred per cent of the poverty 22
income guidelines. 23
[(4)] (7) "Uninsured patient" means any person who is liable for one 24
or more hospital charges whose income is at or below two hundred fifty 25
per cent of the poverty income guidelines who (A) has applied and been 26
denied eligibility for any medical or health care coverage provided 27
under the Medicaid program due to failure to satisfy income or other 28
eligibility requirements, and (B) is not eligible for coverage for hospital 29
services under the Medicare or CHAMPUS programs, or under any 30
Medicaid or health insurance program of any other nation, state, 31
territory or commonwealth, or under any other governmental or 32
privately sponsored health or accident insurance or benefit program 33
including, but not limited to, workers' compensation and awards, 34
settlements or judgments arising from claims, suits or proceedings 35
involving motor vehicle accidents or alleged negligence. 36
(b) (1) No hospital that has provided health care [services] to an 37
uninsured patient may collect from the uninsured patient more than the 38
cost of providing services. 39
(2) No hospital that has provided health care to an underinsured 40
patient on or after October 1, 2020, may collect from the underinsured 41
patient more than the cost of providing services plus interest at an 42
annual rate that is not greater than the lesser of: 43 Raised Bill No. 340
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(A) The weekly average one-year constant maturity yield of United 44
States Treasury securities as published by the Board of Governors of the 45
Federal Reserve System for the week preceding the date on which such 46
underinsured patient first receives a bill for such health care if such 47
average is equal to or greater than two per cent per annum; 48
(B) A rate established by the executive director of the Office of Health 49
Strategy, established under section 19a-754, and in effect on the date on 50
which such underinsured patient first receives a bill for such health care 51
if the Board of Governors of the Federal Reserve System discontinues 52
the rate described in subparagraph (A) of this subdivision; or 53
(C) Five per cent. 54
(c) Each collection agent [, as defined in section 19a-509b,] engaged in 55
collecting a debt from a patient arising from [services] health care 56
provided at a hospital shall provide written notice to such patient as to 57
whether the hospital deems the patient an insured patient , 58
underinsured patient or [an] uninsured patient and the reasons for such 59
determination. 60
Sec. 2. Section 19a-673b of the general statutes is repealed and the 61
following is substituted in lieu thereof (Effective October 1, 2020): 62
(a) No hospital, as defined in section 19a-490, shall refer to a collection 63
agent, as defined in section 19a-509b, or initiate an action against an 64
individual patient or such patient's estate to collect fees arising from 65
health care provided at a hospital: 66
(1) [on] On or after October 1, 2003, unless the hospital has [made a 67
determination whether] determined that such individual patient is [(1)] 68
an uninsured patient, as defined in section 19a-673, as amended by this 69
act, [and (2) not eligible] who is ineligible for the hospital bed fund; [.] 70
or 71
(2) On or after October 1, 2020, unless the hospital has determined 72
that such individual patient is: 73 Raised Bill No. 340
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(A) An uninsured patient, as defined in said section 19a-673, as 74
amended by this act, who is ineligible for the hospital bed fund; or 75
(B) An underinsured patient, as defined in said section 19a-673, as 76
amended by this act, who is ineligible for the hospital bed fund and, if 77
such underinsured patient has requested review of an adverse 78
determination, as defined in section 38a-591a, for health care provided 79
at such hospital, such underinsured patient has not received a final 80
adverse determination, as defined in said section 38a-591a, for such 81
health care. 82
(b) On or after October 1, 2020, no hospital, as defined in section 19a-83
490, and no collection agent, as defined in section 19a-509b, that receives 84
a referral from a hospital, shall: 85
(1) Report an individual patient to a credit rating agency, as defined 86
in section 36a-695, for a period of one year beginning on the date that 87
such patient first receives a bill for health care provided by the hospital 88
to such patient on or after October 1, 2020; 89
(2) Initiate an action to foreclose a lien on an individual patient's 90
primary residence if the lien was filed to secure payment for health care 91
provided by the hospital to such patient on or after October 1, 2020; or 92
(3) Apply to a court for an execution against an individual patient's 93
wages pursuant to section 52-361a, or otherwise seek to garnish such 94
patient's wages, to collect payment for health care provided by the 95
hospital to such patient on or after October 1, 2020, if such patient is 96
eligible for the hospital bed fund. 97
[(b)] (c) Nothing in [this] subsection (a) or (b) of this section shall 98
affect a hospital's ability to initiate an action against an individual 99
patient or such patient's estate to collect coinsurance, deductibles or fees 100
arising from health care provided at a hospital where such coinsurance, 101
deductibles or fees may be eligible for reimbursement through awards, 102
settlements or judgments arising from claims, suits or proceedings. In 103
addition, nothing in [this section] said subsections shall affect a 104 Raised Bill No. 340
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hospital's ability to initiate an action against an individual patient or 105
such patient's estate where payment or reimbursement has been made, 106
or likely is to be made, directly to the patient. 107
Sec. 3. Section 19a-673d of the general statutes is repealed and the 108
following is substituted in lieu thereof (Effective October 1, 2020): 109
If, at any point in the debt collection process, whether before or after 110
the entry of judgment, a hospital, [a consumer collection agency acting 111
on behalf of the hospital, an attorney representing the hospital or any 112
employee or agent of the hospital] as defined in section 19a-490, as 113
amended by this act, or a collection agent, as defined in section 19a-509b, 114
as amended by this act, becomes aware that a debtor from whom the 115
hospital is seeking payment for [services] health care rendered receives 116
information that the debtor has requested review of an adverse 117
determination, as defined in section 38a-591a, for such health care and 118
has not received a final adverse determination, as defined in said section 119
38a-591a, or is eligible for hospital bed funds, free or reduced price 120
hospital services [,] or any other program which would result in the 121
elimination of liability for the debt or reduction in the amount of such 122
liability, [the] such hospital [, collection agency, attorney, employee or 123
agent] or collection agent shall promptly discontinue all collection 124
efforts against such debtor for such health care and refer the collection 125
file for such health care to [the] such hospital [for determination of such 126
eligibility. The] until such hospital determines whether such debtor is 127
eligible for such elimination or reduction or receives such final adverse 128
determination. Such collection [effort] efforts shall not resume until such 129
hospital makes such determination [is made] or such debtor receives 130
such final adverse determination. 131
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2020 19a-673
Sec. 2 October 1, 2020 19a-673b
Sec. 3 October 1, 2020 19a-673d
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Statement of Purpose:
To restrict (1) the amount that a hospital or collection agent may recover
from an uninsured or underinsured patient for the unpaid cost of health
care, and (2) the manner in which a hospital or collection agent may
secure or recover payment for such unpaid cost.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]