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HB 6871 Connecticut House · 2025 Regular Session

AN ACT LIMITING OUT-OF-NETWORK HEALTH CARE COSTS.

HB 6871 limits out-of-network hospital costs for patients covered by health benefit plans. It caps out-of-network charges at 240% of Medicare's reimbursement rate for the same service in the same area, effective January 1, 2026. Health plans must pass savings from these limits to consumers through rate filings, and hospitals must report cost data to the Office of Health Strategy for monitoring. The law exempts rural hospitals and federally qualified health centers from these requirements.
Issues: ✓ HealthcareSupports HealthcareCaps out-of-network costs at 240% Medicare rate, requires health plans to pass savings to consumers, protecting patients from excessive charges.90% confidence
Bill status in committee 1 of 4 stages cleared
Introduction
Feb 2025
Committee Review
Floor Vote
Governor
Introduced Feb 6, 2025 Last action May 6, 2025
Maddy AI version diff · 1 comparison

What changed between versions

Governor's Bill → INS Joint Favorable Substitute · 5 edits
MODERATE
This bill was amended to clarify definitions, update the effective date for cost limits to January 1, 2027, and add new reporting requirements. The changes ensure greater transparency in out-of-network hospital charges while protecting rural hospitals and federally qualified health centers from these restrictions.
Scope change
The bill now explicitly excludes rural hospitals and federally qualified health centers from out-of-network cost limits, and expands the definition of health care providers to include health systems and hospital-based facilities.
TIMELINE

The effective date for out-of-network cost limits was changed from January 1, 2026 to January 1, 2027.

ELIGIBILITY

New exemptions were added for hospitals in rural towns and federally qualified health centers, which are not subject to out-of-network cost limits.

DEFINITION

The definition of 'health care provider' was expanded to explicitly include health systems, hospitals, and hospital-based facilities.

REQUIREMENT

New requirements were added for the Office of Health Strategy to report biannually on in-network and out-of-network cost trends starting January 1, 2028.

TECHNICAL

Minor formatting changes and renumbering of subsections were made to align with substitute bill standards.

Floor votes

How they voted

No floor votes recorded yet.
Full legislative history

Actions timeline

Total actions
15
Key actions
3
Committee
4
May 5, 2025
Lower · Passed
Joint Favorable
lower
Apr 29, 2025
Lower · Passed
REF. BY HOUSE TO COMMITTEE ON Appropriations
lower
Mar 11, 2025
Lower · Passed
Joint Favorable Substitute
lower
Feb 6, 2025
Committee
REF. TO JOINT COMM. ON Insurance and Real Estate
lower
0 primary · 0 co-sponsors

Sponsors

No sponsor information available.