Balance Billing Laws in Connecticut
Your medical billing rights and protections in Connecticut.
Connecticut passed PA 19-117 (2019) and subsequent legislation prohibiting balance billing in emergency and certain non-emergency situations. The state law requires that patients be held harmless from balance bills when receiving care from out-of-network providers at in-network facilities, and provides a dispute resolution process.
Key Protections in Connecticut
Emergency services: Out-of-network emergency providers cannot balance bill; cost-sharing is limited to in-network amounts
Out-of-network at in-network facility: Prohibited from balance billing when patient has no meaningful choice of provider
Dispute resolution: State-administered arbitration process for provider-insurer payment disputes
Notice requirements: Providers must disclose network status before scheduled services
Filing Information
Within 60 days of receiving the bill for state-level complaints
Additional Notes
Connecticut law applies to state-regulated insured plans. Federal NSA applies to self-funded employer plans. Consumers should check their plan type before filing a complaint.
How to File a Complaint in Connecticut
Gather Your Documentation
Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.
File with the State Regulator
Submit your complaint to the Connecticut Insurance Department. Include all supporting documents and a clear description of the billing dispute.
File complaint with Connecticut Insurance DepartmentFile with CMS if Federal Protections Apply
If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.
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