AN ACT CONCERNING HOSPITAL CHARGES FOR UNINSURED 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 Section 19a-673 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2010):

(a) As used in this section:

(1) "Cost of providing services" means a hospital's published charges at the time of billing, multiplied by the hospital's most recent relationship of costs to charges as taken from the hospital's most recently available annual financial filing with the Office of Health Care Access.

(2) "Hospital" means an institution licensed by the Department of Public Health as a short-term general hospital.

(3) "Poverty income guidelines" means the poverty income guidelines issued from time to time by the United States Department of Health and Human Services.

(4) "Uninsured patient" means any person who is liable for one or more hospital charges whose income is at or below two hundred fifty per cent of the poverty income guidelines who (A) has applied and been denied eligibility for any medical or health care coverage provided under the state-administered general assistance program or the Medicaid program due to failure to satisfy income or other eligibility requirements, and (B) is not eligible for coverage for hospital services under the Medicare or CHAMPUS programs, or under any Medicaid or health insurance program of any other nation, state, territory or commonwealth, or under any other governmental or privately sponsored health or accident insurance or benefit program including, but not limited to, workers' compensation and awards, settlements or judgments arising from claims, suits or proceedings involving motor vehicle accidents or alleged negligence.

(b) No hospital that has provided health care services to (1) an uninsured patient, or (2) a patient who does not have health insurance coverage and whose income is above two hundred fifty per cent of the poverty income guidelines may collect from [the uninsured patient] such patients more than the cost of providing services. Any such costs shall be limited to one hundred fifteen per cent of the lowest amount such hospital receives for the relevant procedures or services from any insurer or health care center or from Medicare, whichever is less.

(c) Each collection agent, as defined in section 19a-509b, engaged in collecting a debt from a patient arising from services provided at a hospital shall provide written notice to such patient as to whether the hospital deems the patient an insured patient, a patient who does not have health insurance coverage or an uninsured patient and the reasons for such determination.

Sec. 2. Section 19a-681 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2010):

(a) Each hospital shall file with the office its current pricemaster which shall include each charge in its detailed schedule of charges.

(b) If the billing detail by line item on a patient bill does not agree with the detailed schedule of charges on file with the office for the date of service specified on the bill, the hospital shall be subject to a civil penalty of five hundred dollars per occurrence payable to the state not later than fourteen days after the date of notification. The penalty shall be imposed in accordance with subsections (b) to (e), inclusive, of section 19a-653. The office may issue an order requiring such hospital, not later than fourteen days after the date of notification of an overcharge to a patient, to adjust the bill to be consistent with the schedule of charges on file with the office for the date of service specified on the patient bill.

(c) The office shall post the pricemasters filed under subsection (a) of this section on the Department of Public Health's Internet web site.