Key 2025 Connecticut Health Care Case Law

Pullman & Comley’s annual review of significant health care case law highlights important decisions issued in 2025 by Connecticut state courts and the federal District Court in Connecticut. Among these noteworthy decisions are an interpretation of the Connecticut physician non-compete law in connection with a private equity transaction; a Connecticut District Court ruling on a challenge to the new state statute imposing price caps on prescription drugs; two negligence cases, including a Connecticut Supreme Court decision, that involve the growing number of in-vitro fertilization providers in the state; and a Connecticut Superior Court decision regarding a patient’s claim against a management services organization for improper disclosure of protected health information.

Additionally, this year’s roundup includes the resolution of a longstanding battle between two residential substance abuse providers concerning procedures involving the administration of Connecticut’s Certificate of Need laws and an insured’s claim against a commercial insurance carrier for breach of the covenant and good faith and fair dealing and violation of the Connecticut Unfair Trade Practices Act that survived a motion to strike.

For more detailed and individualized assistance in understanding how these decisions may affect your organization or practice, please contact one of our Health Care Law attorneys.

The purpose of this Alert is to summarize key cases decided during the past year; please refer to the cases for complete information.

Physician Non-Compete Law

Under the Connecticut physician non-compete law (CGS §20-14p), a covenant not to compete is any provision of an “employment or other contract or agreement that creates or establishes a professional relationship with a physician” and restricts the right of the physician to practice medicine in any area of Connecticut for a period of time after termination of the professional relationship. The statute limits permissible covenants to a geographic restriction of 15 miles from the primary site where the physician practices and a temporal restriction of one year. A case decided last year may be of interest to health care providers entering into purchase and sale transactions.

In Sala v. Premier Imaging Holdings, LLC, a radiologist and his fellow shareholders sold their practice to a private equity-backed practice, and the radiologist signed the purchaser’s Limited Liability Company (LLC) Agreement, which contained a non-compete covenant. The covenant restricted the radiologist from practicing within a 25-mile radius of specified hospitals and radiology centers for two years, restrictions that went beyond the limits of the physician non-compete statute. The radiologist breached the non-compete covenant when he began working for another practice, and the purchaser sought to enforce the covenant, arguing that the Connecticut statute was not applicable because the covenant was contained in the LLC Agreement, not an employment agreement. The matter was brought before an arbitrator who determined, without explanation, that the non-compete covenant was valid. The Superior Court (J.D. Hartford) determined that the arbitrator “manifestly disregarded [CGS] §20-14p” because the plain language of the statute makes clear that it is not limited to employment agreements and applies to “any provision of an employment or other contract or agreement that creates or establishes a professional relationship with a physician.” Further, the court found that the LLC Agreement was an integral part of a “package of agreements” pursuant to which the physician and his colleagues sold their radiology practice and that this package of agreements established a professional relationship with the new practice. In vacating the arbitrator’s award, the court noted that “there is no private equity exception to [CGS] §20-14p” and found that enforcing the arbitrator’s award would be against public policy.

Sala v. Premier Imaging Holdings, LLC, 2025 WL 1659375 (June 5, 2025).

Since the enactment of the physician non-compete law in 2016, there have been only a handful of cases interpreting the statute. This case is part of a larger consolidated case involving other physicians in Dr. Sala’s practice and has been appealed to the Appellate Court of Connecticut.

New CT Drug Price Cap Law Survives Motion for Preliminary Injunction

Under Sections 345-347 of Public Act 25-168, effective January 1, 2026 (the “Price Cap Law”), pharmaceutical manufacturers and wholesale distributors are subject to a cap on the prices they may charge for: (1) brand-name drugs or biological products for which the exclusive marketing rights granted under federal law have expired for at least 24 months; and (2) generic drugs or interchangeable biological products. Violators with at least $250,000 in total annual sales in Connecticut for the applicable calendar year are subject to civil penalties. A drug that is determined by the federal Secretary of Health and Human Services to be in shortage will not be subject to the price cap.

A national trade association representing wholesale distributors of prescription drugs located outside of Connecticut sought to enjoin Attorney General William Tong and the Connecticut Department of Revenue Services from enforcing the Price Cap Law against its members. The plaintiff argued that that the Price Cap Law violated the “dormant” Commerce Clause of the U.S. Constitution, which prohibits state laws that benefit in-state economic interests by burdening out-of-state competitors. A state law generally violates the dormant Commerce Clause if it: (i) clearly discriminates against interstate commerce in favor of intrastate commerce; (ii) imposes a burden on interstate commerce incommensurate with the local benefits secured; or (iii) has a specific impermissible extraterritorial effect of discriminating against interstate commerce or directly regulating commerce occurring wholly out-of-state. The U.S. District Court in Connecticut (Williams, J.) denied the injunction, finding that the plaintiff failed to demonstrate that the Price Cap Law would have any of these three effects and therefore that the plaintiff would not likely succeed on the merits of its claims.

The plaintiff also argued that the Price Cap Law violated the Due Process Clause of the Fourteenth Amendment to the U.S. Constitution by attempting to regulate and control activities wholly beyond its boundaries, but the court similarly found that the plaintiff would not likely succeed on the merits of this claim.

Healthcare Distribution Alliance v. Mark D. Boughton (in his official capacity as Commissioner of the Connecticut Department of Revenue Services) and William Tong (in his official capacity as Attorney General for the State of Connecticut), 2025 WL 3725031 (December 24, 2025).

The plaintiff originally argued that the Price Cap Law covered drugs sold outside of Connecticut that were later made available by third parties to patients in Connecticut, but the defendants clarified that they only intend to enforce the law against covered manufacturers and distributors selling identified drugs where title is taken in Connecticut. The court therefore ordered: (i) the plaintiff either to file an amended complaint accounting for the defendants’ clarification concerning the Price Cap Law’s applicability, or a notice that it does not intend to amend the complaint, on or before January 23, 2026; and (ii) the defendants to file a response to the operative complaint within 21 days of the plaintiff’s filing its amendment or notice or on or before February 13, 2026, whichever date is sooner. On December 29, 2025, the plaintiff filed an appeal to the Second Circuit Court of Appeals. We will continue to follow the developments in this important case.

CT Supreme Court Reiterates Distinctions Among Wrongful Life, Wrongful Birth and Ordinary Negligence

Two half-siblings claimed that during an in-vitro fertilization (IVF) procedure, a reproductive endocrinologist impregnated their mothers with his own sperm rather than the sperm of the men whom the siblings believed were their biological fathers, causing emotional harm as well as physical harm to one of the plaintiffs (the defendant was a carrier of a genetic disease). The trial court granted the doctor’s motion to strike the negligence claims because it found that these claims were actually claims for wrongful life, and Connecticut has not determined whether it recognizes claims for wrongful life. (A wrongful life claim is a claim that, but for the negligence of a medical professional, a child would not have been conceived or born, and the child has suffered harm as a result of birth.) The half-siblings appealed to the Connecticut Appellate Court, arguing that their claims were not for wrongful life, but for ordinary negligence. The Connecticut Supreme Court transferred the appeal.

The court stated that, as set forth in prior case law, the defendant in a wrongful life case is not directly responsible for the injury to the child, such as when a child is born with a congenital defect of which the defendant fails to warn the mother in time for an abortion to be performed (where the defect causes the injury). The court distinguished wrongful life cases from this case, where it found that the defendant's deception directly caused the harm to the half-siblings. The court also noted that, in a wrongful life case, the plaintiff alleges that the harm could only have been avoided if the plaintiff had never been born at all. In this case, the court found that the alleged harm could have been avoided if the physician had advised the plaintiffs’ parents of his intention to use his own sperm and the parents had agreed. The court reversed the lower court’s judgment with respect to the plaintiffs’ negligence claims and remanded the case for further proceedings with direction to deny the defendant’s motion to strike these claims and affirmed the judgment in all other respects.  

Suprynowicz v. Tohan, 351 Conn. 75 (January 14, 2025).

The court also distinguished wrongful life cases, which are brought by the child, from wrongful birth cases, which are brought by the parents of a child and which Connecticut recognizes.

Court Denies IVF Provider’s Motion to Dismiss Plaintiffs’ Claims that IVF Resulted in Wrong Gender

Two plaintiffs alleged that an in-vitro fertilization (IVF) provider, its owner and an employee ignored their wishes of having a male and a female embryo implanted in a surrogate and instead implanted two female embryos. The claims included ordinary negligence, negligent infliction of emotional distress, breach of contract, breach of the implied covenant of good faith and fair dealing, breach of fiduciary duty, breach of the Connecticut Unfair Trade Practices Act, misrepresentation, recklessness and breach of the duty to obtain informed consent. The defendants argued that all of the claims, other than the claim regarding informed consent, were medical malpractice claims for which the plaintiffs did not provide an opinion letter of a similar health care provider as required by CGS §52-190a. The Superior Court (J.D. Bridgeport) disagreed and denied the defendants’ motion to dismiss.

The court discussed the confusing nature of the allegations and determined that the defendants summarily characterized the claims (other than the informed consent claim) as medical negligence without explanation. The court was left to decide which of the claims could conceivably be construed as medical malpractice claims and which could not. It concluded that the plaintiffs’ claims generally were not written in terms of negligence and that the implantation of the two female embryos was not dictated by medical judgment. Instead, the court found that the plaintiffs’ allegations centered on the defendants’ failure to perform contractual obligations and that the defendants failed to address why these allegations were within the scope of medical malpractice.

Doe v. New England Fertility Institute LLC, 2025 WL 3079111 (October 30, 2025).

The court also found that it would be premature to grant the defendants’ motion at this stage of the proceedings because it was unclear what issues would be addressed in the ensuing litigation, though the court did note that the plaintiffs committed themselves to claims that do not rely on conduct that can be deemed to be medical negligence. 

Superior Court Strikes Patient’s Claims Against MSO Arising from Breach of PHI by Employee of Health Care Provider

An employee of a health care practice inappropriately accessed the medical records of a patient numerous times and posted some of the patient’s protected health information on social media, including but not limited to, the patient’s name, medical history and radiology reports. The patient sued not only the practice but also the management services organization (MSO) that provided administrative services to the practice for breach of contract, negligent infliction of emotional distress and negligence. A Superior Court (J.D. Bridgeport) granted the MSO’s motion to strike the claims brought against it.

The court found that the breach of contract claim was not viable because there was no evidence to support a contractual relationship between the patient and the MSO. With respect to the claims of negligent infliction of emotional distress and negligence, the court noted that these claims first require that the defendant owe a duty to the plaintiff. The patient claimed that the disclosure was a breach of the fiduciary duty of confidentiality under a physician-patient relationship, but the court found that no physician-patient relationship existed because the MSO was not a health care provider. The patient further argued that the MSO had an affirmative duty to protect her medical records from unauthorized access, but because she did not allege this duty in her complaint (she raised it in her opposition memorandum to the MSO’s motion to strike), the court did not consider this argument.

Marmol v. Women’s Health Connecticut, Inc., 2025 WL 2505774 (August 25, 2025).

Query whether the court would have struck the plaintiff’s claims for negligent infliction of emotional distress and negligence if the patient had pled in her complaint, instead of in her opposition memorandum, that the MSO had an affirmative duty to protect her medical records from unauthorized access.

Further Developments Concerning the Birch Hill CON

In past case law updates, we reported on decisions involving the certificate of need (CON) filed by Birch Hill Recovery Center, LLC (Birch Hill) for the establishment of a substance abuse treatment facility in Kent and the opposition to this CON by High Watch Recovery Center, Inc. (High Watch). After initially denying Birch Hill’s CON application, the Department of Public Health (DPH) entered into an agreed settlement with Birch Hill. High Watch was granted intervenor status and claimed that approval of Birch Hill’s facility would harm High Watch’s ability to attract patients with commercial insurance and that the monies received from these patients helped to fund High Watch’s treatment of indigent patients. High Watch also claimed that the private settlement discussions between DPH and Birch Hill that led to the agreed settlement deprived High Watch of its right to be heard as an intervenor. In 2024, the Superior Court (J.D. New Britain) determined that the business model of a competitor is not within the zone of interests protected by the CON statute and that High Watch was not aggrieved with respect to the private settlement discussions between OHS and Birch Hill.

In 2025, the Supreme Court of Connecticut transferred the appeal and affirmed the decision.

High Watch Recovery Center, Inc. v. Department of Public Health, 352 Conn. 697 (August 5, 2025).

This ruling underscores OHS’s position that competitive harm alone is not a basis for denial of a CON.

Separately, Birch Hill sued High Watch, claiming that High Watch engaged in tortious interference with prospective business relations and violated the Connecticut Unfair Trade Practices Act by, among other things, alerting the public about Birch Hill’s proposed plans and about a hearing before the Office of Health Care Access (now the Office of Health Strategy) at which the public could voice their concerns. The Superior Court (J.D. Litchfield) found that High Watch’s statements were protected as free speech under Connecticut’s “anti-SLAPP” statute, which permits special motions to dismiss claims that are based on the right to free speech with respect to matters of public concern. The court further found that Birch Hill did not meet its burden under the anti-SLAPP statute to establish that there was probable cause that it would prevail on its claims against High Watch. The Appellate Court affirmed this decision.

Birch Hill Recovery Center, LLC v. High Watch Recovery, Inc., 233 Conn.App. 182 (June 10, 2025).

Birch Hill also argued that High Watch’s intervention in the proceedings before the Office of Health Care Access was frivolous and constituted an exception to High Watch’s first amendment defense. The Appellate Court disagreed, noting that this “sham litigation” exception is a high bar to meet. Among other things, the court found that DPH’s findings in the agreed settlement were consistent with many of the arguments that High Watch had made in its motion to intervene and weighed heavily against Birch Hill’s claim that High Watch lacked an objectively reasonable basis for its allegations.

Court Denies Home Health Provider’s Motion regarding Claims of Vicarious Liability and Negligent Supervision Concerning a Caregiver

A Superior Court (J.D. Hartford) denied a home health care provider’s motion for summary judgment in connection with claims brought by the administrator of a resident’s estate alleging that a caregiver employed by the home health provider engaged in violent conduct toward the resident. The caregiver was charged with and pled guilty to criminal offenses related to her treatment of the resident.

The home health provider argued that it was not vicariously liable because the caregiver’s misconduct (which included pushing, slapping, kicking and pulling the resident) fell outside the scope of her employment and was not in furtherance of its business. The court found that the evidence could reasonably support a finding that the caregiver committed the acts in furtherance of the home health provider’s business because the acts occurred at the caregiver’s workplace (the resident’s home) during work hours and there was evidence that the violent acts directly related to her work as a caregiver insofar as they occurred while the caregiver was helping the resident get to the bathroom or get up from a fall.

The court also denied the home care provider’s motion for summary judgment with respect to the claim of negligent supervision. The court found that the resident’s care plan required supervisory visits every 30 days, but the plan was not properly followed on two consecutive occasions. Further, the court determined that it would be reasonable to infer that the home care provider would anticipate that harm of the general nature that the resident suffered would occur and that a jury would take into account other factors that would bear on whether the home care provider had engaged in negligent supervision.

Lucas v. McLennon, 2025 WL 2506123 (August 29, 2025).

While the court was only ruling on a preliminary motion in this case, home health providers should note that adherence to a resident’s care plan is crucial and may provide at least some defense in cases where an individual caregiver provides any type of substandard services.

Superior Court Finds Expert Witness Fee Unreasonably High

Connecticut law (CGS §52-260(f)) requires a court to determine a reasonable fee to be paid to a “practitioner of the healing arts” and others who provide expert testimony in an action, proceeding or deposition.

Following a trial for medical malpractice at which the defendant physician prevailed, the physician submitted to the plaintiff a bill of cost that included the fees for the defense’s expert witnesses (an orthopedic surgeon and a cardiologist) who testified during the trial. The cardiologist charged a flat fee of $6,000 for two hours of testimony, while the orthopedic surgeon charged a flat fee of $12,000 for a little over one hour of testimony. The plaintiff objected that these fees were unreasonable.

The Superior Court (J.D. Stamford/Norwalk) determined that charging flat fees was justified for each witness because each had to cancel a full day of appointments. The court then calculated the hourly fee for each witness based on an eight-hour day, which equaled $750/hour for the cardiologist and $1,500/hour for the orthopedic surgeon. Citing prior case law, the court considered several factors to determine the reasonableness of expert fees, including fees determined reasonable by other courts. It concluded that the cardiologist’s fee was reasonable, but the orthopedic surgeon’s fee was not.

Thomas v. Schmidt, 2025 WL 842156 (March 11, 2025).

The court noted that, if called upon, it would have also ruled that the $1,250/hour fee of the plaintiff’s expert witness (a cardiologist) was excessive. In setting their rates, health care providers who engage or serve as expert witnesses should consider how they would be able to substantiate their charges if challenged by an adverse party or the court. Similar fees charged by other experts appears to be a strong factor in determining what constitutes reasonableness.

Superior Court Denies Health Insurer’s Motion to Strike Claim Alleging Breach of Covenant of Good Faith and Fair Dealing

A father and his daughter sued their health insurance company, ConnectiCare, as well as OptumHealth Behavioral Solutions (which provides administrative and processing services to ConnectiCare (Optum)), for denying their claims for benefits and continued treatment. The daughter had received out-of-network residential mental health services, and the defendants denied payment on the basis that the services were not covered by the plan. Following their unsuccessful appeals to ConnectiCare and Optum, the plaintiffs requested an external review, which also denied payment. The plaintiffs claimed that the denial of benefits (along with the defendants’ failure to comply with the plaintiffs’ request for the criteria used for mental health and substance use disorder treatment) was a breach of the covenant of good faith and fair dealing that is implied in every contract. The defendants argued that the claim was insufficient because it failed to allege that their actions were undertaken in bad faith or motivated by a dishonest purpose.

The Superior Court (J.D. Hartford) denied the defendants’ motion to strike this claim. The court noted a split among Superior Court decisions regarding the level of specificity that is sufficient to support an inference of bad faith. The majority position requires specific allegations of wanton and malicious injury and evil motive, while the minority position generally requires that a plaintiff need only allege sufficient facts from which a reasonable inference of sinister motive can be made. In this case, the court determined that the less stringent standard of the minority position best aligned with the requirement that, on a motion to strike, the court view the allegations in the light most favorable to the plaintiff.

The plaintiffs also claimed that the defendants violated the Connecticut Unfair Trade Practices Act (CUTPA) by engaging in conduct that violated the Connecticut Unfair Insurance Practices Act (CUIPA) as well as the federal Mental Health Parity and Addiction Equity Act (MHPAEA), which generally requires insurance plans to provide no less generous coverage of mental health and substance use disorder treatment than they do for medical or surgical disorders. The court denied the defendants’ motion to strike the CUTPA count based on a violation of CUIPA. It found, among other things, that the allegation amounted to more than a simple coverage dispute, which would not be actionable under CUIPA. However, the court granted the defendants’ motion to strike the CUTPA claim based on violations of the MHPAEA because, unlike violations of CUIPA, violations of the MHPAEA have not been held to constitute violations of CUTPA.

Zarabet v. ConnectiCare, 2025 WL 762609 (March 7, 2025).

While the court was only ruling on the defendants’ motion to strike portions of the plaintiffs’ amended complaint, this case underscores that CUIPA is not the only basis on which patients may predicate allegations of failure to pay insurance claims— basic principles of contract law regarding the implied covenant of good faith and fair dealing might also be successfully alleged.

Superior Court Finds Nursing Home Arbitration Agreement Enforceable

A party seeking to enforce an arbitration provision in Connecticut must first present evidence demonstrating an enforceable agreement to arbitrate. Once this party meets its obligation, the party opposing arbitration must submit facts showing a dispute regarding the making of the agreement to arbitrate.

A short-term resident of a nursing home and his wife brought medical negligence and loss of consortium claims against the nursing home in court based on injuries the resident sustained after falling several times during his stay at the nursing home. The nursing home sought to compel arbitration as set forth in the admission agreement.

The Superior Court (J.D. New Haven) found that the nursing home presented sufficient evidence that the arbitration provision was enforceable. For example, a nursing home employee read the arbitration provision to him before he signed. The court found this relevant in negating the plaintiffs’ assertion that the resident was on multiple medications and in an “uncertain mental condition” when he signed the admission agreement and that he had already fallen twice at the time he signed it. Other claims brought by the plaintiffs asserted that the arbitration provision did not comply with federal law (42 CFR §483.70(m)), which prohibits a nursing home resident from signing an arbitration agreement as a condition of admission or continued care and requires the facility to ensure that the agreement is explained in a form and manner that the resident understands. The plaintiffs also suggested that the failure of the nursing home to read or explain the agreement to the resident’s wife offended fairness because she had no opportunity to agree to or revoke it.

Ultimately, the court determined that the plaintiffs did not meet their burden of demonstrating that there was an issue as to the making of the agreement to arbitrate. It found that the plaintiffs offered no evidence that the resident was incapable of understanding the agreement when he signed it or that the manner in which the nursing home employee read the agreement to the resident rendered the resident unable to understand it. The court also rejected the plaintiffs’ argument that the nursing home had a duty to provide the resident’s wife with an opportunity to reject the agreement.

Casson v. Meriden Care Center, LLC, 2025 WL 1565065 (May 28, 2025).

While the facts of this case would seem, at first glance, to weigh in favor of the plaintiffs given that the resident had fallen twice by the time he signed the arbitration provision, this case illustrates that arbitration agreements are generally favored by courts in Connecticut as a means of avoiding the formalities, delay and expense of litigation.