Connecticut House Bill HB05551

Connecticut 2021 Regular Session

• Introduced: 1/26/21
• Refer: 1/26/21

Caption

An Act Prohibiting Balance Billing And Providing Additional Protection To Health Care Consumers.

Impact

If enacted, HB 05551 would significantly impact the way medical billing is handled for patients receiving care from out-of-network providers. It aims to eliminate the practice of balance billing, where patients are billed for the difference between what their insurance pays and what the provider charges. This legislation would require healthcare providers to adhere to a more standardized billing process, potentially alleviating financial burdens on patients and making healthcare costs more predictable and manageable. Positive impacts would likely be felt by many consumers, particularly in emergency situations or unforeseen medical needs where patients have limited control over their choice of providers.

Summary

House Bill 05551 is designed to amend existing statutes to prohibit certain out-of-network healthcare providers from engaging in balance billing practices, thereby protecting healthcare consumers from unexpected medical charges. The central aim of the bill is to enhance consumer protections in the healthcare sector, particularly addressing the concerns related to unforeseen costs incurred during medical treatments when patients are treated by providers not participating in their health insurance network. The terms specified in the bill suggest a move toward ensuring transparency and fairness in billing processes for consumers seeking medical care.

Contention

Despite its intended benefits, the bill may face opposition from certain stakeholders within the healthcare industry. Providers may argue that prohibiting balance billing limits their ability to negotiate fees for services rendered, potentially leading to reduced reimbursement rates for out-of-network care. Additionally, questions surrounding the enforcement of these regulations and how it might interplay with existing contracts between insurers and providers could fuel ongoing discussions and debates. Thus, while the bill is poised to enhance consumer rights in healthcare, it brings forth concerns regarding its broader implications on the healthcare market dynamics and provider-payer relationships.