Sec. 38a-226b. Violations. Notice and hearing. Penalties. Appeal.
Sec. 38a-226b. Violations. Notice and hearing. Penalties. Appeal. (1) Whenever
the commissioner has reason to believe that a utilization review company subject to
sections 38a-226 to 38a-226d, inclusive, has been or is engaging in conduct in violation
of said sections, and that a proceeding by the commissioner would be in the interest of
the public, the commissioner shall issue and serve upon such company a statement of
the charges in that respect and a notice of a hearing to be held at a time and place fixed
in the notice, which shall not be less than thirty days after the date of service. At the
time and place fixed for such hearing, such company shall have an opportunity to be
heard and to show cause why an order should not be made by the commissioner requiring
such company to cease and desist from the alleged conduct complained of.
(2) If, after such hearing, the commissioner determines that the utilization review
company charged has engaged in a violation of sections 38a-226 to 38a-226d, inclusive,
the commissioner shall reduce the findings to writing and shall issue and cause to be
served upon the utilization review company a copy of such findings and an order requiring such company to cease and desist from engaging in such violation. The commissioner
may order any of the following:
(A) Payment of a civil penalty of not more than one thousand five hundred dollars
for each act or violation, provided such penalty shall not exceed an aggregate penalty
of fifteen thousand dollars unless the company knew or reasonably should have known
it was in violation of sections 38a-226 to 38a-226d, inclusive, in which case the penalty
shall be not more than seven thousand five hundred dollars for each act or violation not
to exceed an aggregate penalty of seventy-five thousand dollars in any six-month period;
(B) Suspension or revocation of the utilization review company's license to do
business in this state if it knew or reasonably should have known that it was in violation
of sections 38a-226 to 38a-226d, inclusive; or
(C) Payment of such reasonable expenses as may be necessary to compensate the
commissioner in connection with the proceedings under this subdivision, which shall
be dedicated exclusively to the regulation of utilization review.
(3) Any company aggrieved by any such order of the commissioner may appeal
therefrom in accordance with the provisions of section 4-183, except venue for such
appeal shall be in the judicial district of New Britain.
(4) Any person who violates a cease and desist order of the commissioner made
pursuant to this section and while such order is in effect shall, after notice and hearing
and upon order of the commissioner, be subject to the following: (A) A civil penalty of
not more than seventy-five thousand dollars; or (B) suspension or revocation of such
person's license.
(P.A. 88-230, S. 1, 12; P.A. 90-98, S. 1, 2; P.A. 91-305, S. 3; P.A. 93-142, S. 4, 7, 8; P.A. 95-220, S. 4-6; P.A. 97-99,
S. 17; P.A. 99-215, S. 24, 29; P.A. 08-178, S. 8.)
History: (Revisor's note: P.A. 88-230 and P.A. 90-98 authorized substitution of "judicial district of Hartford" for
"judicial district of Hartford-New Britain" in public and special acts of the 1991 session of the general assembly, effective
September 1, 1993); P.A. 93-142 changed the effective date of P.A. 88-230 from September 1, 1993, to September 1, 1996,
effective June 14, 1993; P.A. 95-220 changed the effective date of P.A. 88-230 from September 1, 1996, to September 1,
1998, effective July 1, 1995; P.A. 97-99 changed "Insurance Department" to "commissioner" in Subsec. (2)(C); P.A. 99-215 replaced "judicial district of Hartford" with "judicial district of New Britain" in Subsec. (3), effective June 29, 1999;
P.A. 08-178 made technical changes, amended Subsec. (2)(A) by increasing maximum penalty from $1,000 to $1,500 per
violation and aggregate maximum penalty from $10,000 to $15,000, and for violations of which the company knew or
reasonably should have known, increasing maximum penalty from $5,000 to $7,500 per violation and aggregate maximum
penalty in any 6-month period from $50,000 to $75,000, and amended Subsec. (4)(A) by increasing maximum penalty
from $50,000 to $75,000.