AN ACT CONCERNING HOSPITAL UNCOMPENSATED CARE.

Senate
sSB496 / File No. 485 1

General Assembly File No. 485
February Session, 2026 Substitute Senate Bill No. 496

Senate, April 7, 2026

The Committee on Human Services reported through SEN.
LESSER of the 9th Dist., Chairperson of the Committee on the
part of the Senate, that the substitute bill ought to pass.

AN ACT CONCERNING HOSPITAL UNCOMPENSATED CARE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. (NEW) (Effective October 1, 2026) (a) As used in this section, 1
(1) "hospital" has the same meaning as provided in section 19a -490 of 2
the general statutes, (2) "hospital financial assistance" means any 3
program administered by a hospital or health system, including a bed 4
fund, as defined in section 19a-509b of the general statutes, that reduces, 5
in whole or in part, a patient's liability for the cost of inpatient or 6
outpatient care, and (3) "hospital financial assistance program" means a 7
program in which a participating hospital provides inpatient and 8
outpatient care: 9
(A) At no cost to an uninsured patient with income not exceeding two 10
hundred per cent of the federal poverty level; 11
(B) Subsidized by hospital financial assistance for an uninsured 12
patient with income exceeding two hundred per cent of the federal 13
poverty level but not exceeding three hundred per cent of the federal 14
sSB496 File No. 485

sSB496 / File No. 485 2

poverty level; 15
(C) Subsidized with hospital financial assistance for any patient with 16
income not exceeding four hundred per cent of the federal poverty level 17
who is enrolled in (i) the federal supplemental nutrition assistance 18
program, or (ii) the federal Special Supplemental Food Program for 19
Women, Infants and Children; and 20
(D) For patients with household income under two hundred per cent 21
of the federal poverty level who are deemed ineligible for hospital 22
financial assistance, billed in accordance with a payment schedule 23
amounting to not more than two per cent of such patient's annual 24
household income per year. After a cumulative thirty -six months of 25
payments by such patient, each participating hospital shall consider the 26
patient's hospital bill paid in full and permanently cease any and all 27
collection activities on any balance that remains unpaid. 28
(b) A hospital may opt in to the hospital financial assistance program 29
and be reimbursed pursuant to section 2 of this act. A participating 30
hospital shall not (1) count a patient's assets when determining 31
eligibility for hospital financial assistance, or (2) require the patient to 32
provide proof that the patient's application for benefits under the state 33
medical assistance program, Medicare, Emergency Medicaid, other 34
government-funded coverage or insurance through the Connecticut 35
Health Insurance Exchange was denied. A hospital shall use software 36
that conforms to industry standards concerning electronic income 37
verification and may accept one of the following documents to verify 38
income: 39
(A) A copy of the patient's most recent tax return; 40
(B) A copy of the patient's most recent W-2 form and 1099 forms; 41
(C) Copies of the patient's two most recent pay stubs; or 42
(D) Written income verification from an employer if the patient is 43
paid in cash. 44
sSB496 File No. 485

sSB496 / File No. 485 3

(c) A participating hospital shall exempt patients who are 45
experiencing homelessness or are at imminent risk of homelessness 46
from providing documentation pursuant to subsection (b) of this section 47
but may require such patients to provide self -attested information for 48
both a hospital financial assistance screening and hospital financial 49
assistance application. 50
(d) Notwithstanding the provisions of section 19a-509b of the general 51
statutes, a participating hospital shall make information available on the 52
hospital financial assistance program in each of the top non -English 53
languages spoken by five or more per cent of the population that reside 54
in the geographic area served by the hospital. Such information shall (1) 55
be included in all discharge paperwork and on the hospital's Internet 56
web site, (2) contain contact information for the Office of the Health Care 57
Advocate, and (3) comply with requirements concerning effective 58
communications under the Americans with Disabilities Act, including, 59
but not limited to, communications delivered through relay services, 60
interpretation, large print and braille. 61
Sec. 2. (NEW) ( Effective October 1, 2026 ) (a) As used in this section, 62
"disproportionate share hospital payment" means a Medicaid payment 63
to a hospital that serves a disproportionately large number of Medicaid 64
beneficiaries and uninsured individuals. The Commissioner of Social 65
Services shall amend the Medicaid state plan to use disproportionate 66
share hospital payments to compensate hospitals that participate in the 67
hospital financial assistance program established pursuant to section 1 68
of this act. 69
(b) The Commissioner of Social Services shall establish criteria for a 70
participating hospital to document hospital financial assistance and 71
receive timely payment for such assistance. 72
(c) A hospital aggrieved by a final decision by the commissioner on 73
the validity of such hospital's bills for hospital financial assistance may 74
file an appeal in accordance with the provisions of section 17b-238 of the 75
general statutes, as amended by this act. 76
sSB496 File No. 485

sSB496 / File No. 485 4

Sec. 3. Subsection (b) of section 17b-238 of the 2026 supplement to the 77
general statutes is repealed and the following is substituted in lieu 78
thereof (Effective October 1, 2026): 79
(b) Any institution or agency to which payments are to be made 80
under sections 17b-239 to 17b-246, inclusive, and sections 17b-340, [and] 81
17b-343 and section 2 of this act which is aggrieved by any decision of 82
said commissioner may, within ten days after written notice thereof 83
from the commissioner, obtain, by written request to the commissioner, 84
a rehearing on all items of aggrievement. On and after July 1, 1996, a 85
rehearing shall be held by the commissioner or his designee, provided a 86
detailed written description of all such items is filed within ninety days 87
of written notice of the commissioner's decision. The rehearing shall be 88
held within thirty days of the filing of the detailed written description 89
of each specific item of aggrievement. The commissioner shall issue a 90
final decision within sixty days of the close of evidence or the date on 91
which final briefs are filed, whichever occurs later. Any designee of the 92
commissioner who presides over such rehearing shall be impartial and 93
shall not be employed within the Department of Social Services office of 94
certificate of need and rate setting. Any such items not resolved at such 95
rehearing to the satisfaction of either such institution or agency or said 96
commissioner shall be submitted to binding arbitration to an arbitration 97
board consisting of one member appointed by the institution or agency, 98
one member appointed by the commissioner and one member 99
appointed by the Chief Court Administrator from among the retired 100
judges of the Superior Court, which retired judge shall be compensated 101
for his services on such board in the same manner as a state referee is 102
compensated for his services under section 52 -434. The proceedings of 103
the arbitration board and any decisions rendered by such board shall be 104
conducted in accordance with the provisions of the Social Security Act, 105
49 Stat. 620 (1935), 42 USC 1396, as amended from time to time, and 106
chapter 54. 107
Sec. 4. Subsection (b) of section 17b-238 of the 2026 supplement to the 108
general statutes, as amended by section 348 of public act 25 -168, is 109
repealed and the following is substituted in lieu thereof (Effective January 110
sSB496 File No. 485

sSB496 / File No. 485 5

1, 2027): 111
(b) Any institution or agency to which payments are to be made 112
under sections 17b-239 to 17b-246, inclusive, and sections 17b-340, [and] 113
17b-343 and section 2 of this act which is aggrieved by any decision of 114
said commissioner may, within ten days after written notice thereof 115
from the commissioner, obtain, by written request to the commissioner, 116
a rehearing on all items of aggrievement. On and after July 1, 1996, a 117
rehearing shall be held by the commissioner or his designee, provided a 118
detailed written description of all such items is filed within ninety days 119
of written notice of the commissioner's decision. The rehearing shall be 120
held within thirty days of the filing of the detailed written description 121
of each specific item of aggrievement. The commissioner shall issue a 122
final decision within sixty days of the close of evidence or the date on 123
which final briefs are filed, whichever occurs later. Any designee of the 124
commissioner who presides over such rehearing shall be impartial and 125
shall not be employed within the Department of Social Services office of 126
certificate of need and rate setting. Any such items not resolved at such 127
rehearing to the satisfaction of either such institution or agency or said 128
commissioner may be appealed in accordance with section 4 -183. Such 129
appeals shall be privileged cases to be heard by the court as soon after 130
the return date as shall be practicable. 131
This act shall take effect as follows and shall amend the following
sections:

Section 1 October 1, 2026 New section
Sec. 2 October 1, 2026 New section
Sec. 3 October 1, 2026 17b-238(b)
Sec. 4 January 1, 2027 17b-238(b)

Statement of Legislative Commissioners:
Sections 1(b)(2) and (c) were redrafted for clarity; in Section 2(c), "17b -
60" was changed to "17b -238" for accuracy; and Sections 3 and 4 were
added for accuracy and statutory consistency.

HS Joint Favorable Subst. -LCO

sSB496 File No. 485

sSB496 / File No. 485 6

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of
the General Assembly, solely for purposes of information, summarization and explanation and do not
represent the intent of the General Assembly or either chamber thereof for any purpose. In general,
fiscal impacts are based upon a variety of informational sources, including the analyst’s professional
knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final
products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact:
Agency Affected Fund-Effect FY 27 $ FY 28 $
UConn Health Ctr. GF - Potential
Revenue Gain
See Below See Below
Social Services, Dept. GF - Cost See Below See Below
Note: GF=General Fund

Municipal Impact: None
Explanation
Section 1 results in a potential revenue gain to the UConn Health
Center (UCHC) annually beginning in FY 27. It allows any hospital,
including UCHC, to participate in a financial assistance program
established by the bill for patients who meet certain income and ot her
criteria. Presumably, UCHC would only choose to participate if the
program increased net patient revenue, and the bill's reimbursement
from DSS offset the cost of participating in this program. Any revenue
gain would depend on: (1) the number of qualif ying patients who
participate; and (2) how the program's changes in qualifying patient
payments compare to the reimbursement UCHC would receive from
DSS.
In the past 12 months, UConn Health has served at least 5,299
uninsured patients and 749 insured patients who met the bill's income
parameters.1 On average, the uninsured patients who met the bill's

1 These numbers represent the number of insured and uninsured patients at UCHC
who have applied for financial assistance in the past 12 months and otherwise meet
the bill's eligibility parameters. These figures do not include patients who may be
eligible to participate in the bill's financial assistance program due to participation in
SNAP or WIC.
sSB496 File No. 485

sSB496 / File No. 485 7

income parameters owed $810 out -of-pocket, and they ultimately paid
63% to 72% of that amount (i.e., $227 to $300 is left unpaid). The insured
patients owed $301, and they ultimately paid 69% to 81% of that amount
(i.e., $57 to $93 left unpaid).
Section 2 results in a Medicaid cost to the Department of Social
Services (DSS) associated with disproportionate share hospital
payments (DSH). The bill requires DSS to make DSH payments to
hospitals as compensation for participating in the hospital financial
assistance program established by the bill, using criteria to be identified
by DSS. The extent of the cost to DSS is unknown and will be based on
participating hospitals, criteria developed, and relevant costs. For
context, DSH payments must meet federal requirements in order for
states to receive a 50% federal share and are subject to both hospital and
state specific limits.
DSS may also incur increased administrative costs to the extent
participating hospitals utilize the appeals process authorized by the bill.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to the scope of allowable DSH payments.

sSB496 File No. 485

sSB496 / File No. 485 8

OLR Bill Analysis
sSB 496

AN ACT CONCERNING HOSPITAL UNCOMPENSATED CARE.

SUMMARY
This bill establishes a voluntary hospital financial assistance program
that requires participating hospitals to provide financial assistance to
patients if they meet specified income thresholds and, in some cases, are
enrolled in certain federal nutrition assistance programs. The financial
assistance, which may include a hospital bed fund, must partially or
totally reduce a patient’s liability for the cost of care. (Generally, a
hospital bed fund refers to donations of money, stock, or other property
to a hospital to provide free patient care.)
The bill sets related eligibility and care requirements for participating
hospitals and authorizes them to be reimbursed by disproportionate
share hospital payments (DSH), which are Medicaid payments to
hospitals that serve a disproportionately large number of Medicaid and
uninsured patients.
Correspondingly, the bill requires the Department of Social Services
(DSS) commissioner to amend the Medicaid state plan to use DSH
payments to compensate participating hospitals and set criteria for them
to document the financial assistance they provide a nd receive timely
payment for it.
Under the bill, a hospital aggrieved by the commissioner’s final
decision on the validity of the hospital’s bills for financial assistance may
request a rehearing using existing law’s process for DSS payment rates
and audits. Under this process, hospitals may appeal any items not
resolved at a rehearing to the Superior Court, as authorized under the
Uniform Administrative Procedure Act.

sSB496 File No. 485

sSB496 / File No. 485 9

EFFECTIVE DATE: October 1, 2026, except that the provision
allowing an aggrieved hospital to request a rehearing takes effect
January 1, 2027.
VOLUNTARY HOSPITAL FINANCIAL ASSISTANCE PROGRAM
Care Requirements
Under the bill, hospitals that choose to participate in the bill’s hospital
financial assistance program must provide inpatient and outpatient care
as follows:
1. for free to uninsured patients with income up to 200% of the
federal poverty level (FPL);
2. subsidized care to uninsured patients with income between 201%
and 300% FPL; and
3. subsidized care for patients with income up to 400% FPL who are
enrolled in the (a) federal Supplemental Nutrition Assistance
Program (SNAP) or (b) Special Supplemental Food Program for
Women, Infants, and Children (WIC).
For patients with incomes under 200% FPL who are ineligible for
financial assistance, the bill requires participating hospitals to bill them
according to a payment plan that is less than 2% of their annual
household income. After 36 cumulative monthly paym ents, hospitals
must consider these patients’ bills paid in full and permanently stop
collection activities on any remaining balance.
Eligibility Requirements
The bill prohibits participating hospitals from (1) counting a patient’s
assets when determining their program eligibility or (2) requiring a
patient to provide proof of a denial letter from a public insurance
program (the Connecticut Medical Assistance Pr ogram, Emergency
Medicaid, and Medicare) or insurance through the statewide health
exchange (Access Health CT).
Hospitals must use software that meets industry standards on
sSB496 File No. 485

sSB496 / File No. 485 10

electronic income verification and may accept one of the following
documents to verify a patient’s income:
1. a copy of the patient’s most recent tax return or W -2 and 1099
forms,
2. copies of the patient’s two most recent pay stubs, and
3. an employer’s written income verification if the patient is paid in
cash.
The bill exempts from these income verification requirements
patients who are experiencing (or are at imminent risk of) homelessness
but allows hospitals to require them to provide self-attested information
for a program screening or application.
Program Information in Other Languages
Regardless of the state’s law on hospital bed funds (see
BACKGROUND), the bill requires participating hospitals to make
available financial assistance program information in the other
languages spoken by at least 5% of the population living in the
geographic area the hospital serves.
Under the bill, the information must (1) be included in all discharge
paperwork and on the hospital’s website, (2) have the Office of the
Health Care Advocate’s contact information, and (3) comply with the
federal Americans with Disabilities Act requiremen ts for effective
communication (providing free auxiliary aids and services, such as
braille, large print, and relay services).
BACKGROUND
Hospital Bed Fund Patient Summaries
Existing law requires each hospital that maintains or administers bed
funds to make available to patients a one-page plain language summary
in English and Spanish on its financial assistance policy.
sSB496 File No. 485

sSB496 / File No. 485 11

COMMITTEE ACTION
Human Services Committee
Joint Favorable
Yea 16 Nay 7 (03/19/2026)