New News for the Practice ---helping Physicians Cope

2016 brings two new laws: 

The first big transparency provisions in took effect Jan. 1:

Health care providers must determine if patients who schedule nonemergency care are uninsured or if the provider is outside the patient’s insurance network. If so, the provider must tell the patient in writing how much will be charged. For patients whose insurer doesn’t include the provider in its network, the notice must indicate that the care will probably be subject to out-of-network rates.
If a patient is charged a facility fee – additional fees that hospital-owned facilities can charge, which sometimes amount to thousands of dollars – the bill must “clearly identify” the fee and tell the patient that they might have paid less had they gone to a facility not owned by the hospital.    It must also mention the patient’s right to request a fee reduction and, for comparison, the facility fee Medicare would pay.
If a hospital acquires a medical office or practice that is likely to charge facility fees, it must notify patients that, among other things, they could face higher costs.

Connecticut has a six-year statute of limitations for debt collection actions resulting from simple and implied contracts (CGS § 52-576; attachment 1). Medical bills generally are simple or implied contracts and thus the SOL is six years. Creditors attempting to collect past-due debt, must bring an action in court (known as an action for account) within six years of the time the right of action accrues or the claim is barred by operation of the statute. Determining when the right accrues depends on the circumstances involved; for example, if a debtor made occasional payments for a few years and then stopped, the right accrues when the debtor defaults, not when the original debt occurred. The time limit is tolled for people legally incapable of bringing an action; they have three years from the time that they become legally capable. The statute of limitation is an affirmative defense, it must be pled.

While the action must be brought within six years, but a judgment on the action may come later. Collection of a debt evidenced by a judgment is not time-barred, except that there is common law presumption of payment after 20 years (LaBarre V. V.P.A. Quinn, 17 Conn. Sup. 134 (1950)).

In the event that such debt is turned over to or sold to a collection agency, it is still within the SOL (they must bring an action within the original six-year period). For information on the state and federal laws governing collection agency conduct and practices see OLR Report 95-R-1120 (attachment 2).

Generally, the purpose of SOLs is preventing stale claims against unexpecting defendants. Stale claims present unique issues for courts because defendants may be caught “off-guard” by lapse of time, records may have been destroyed, and memories may have faded. SOLs protect citizens from such claims and relieve the courts of these problems. The rational is that the occasional hardship of barring a just claim is outweighed by the advantage of outlawing stale claims (Lametta v. Connecticut Light & Power Co.,139 Conn. 218 (1953)).