Prohibits certain contractual provisions in provider contracts with health insurance issuers
Impact
The implications of HB 1140 are significant for both healthcare providers and managed care organizations. By empowering providers with the option to participate selectively in health benefit plans, the bill offers a degree of protection against potential contract termination based on non-participation in all offerings by the insurer. This legislative change is expected to create a more balanced power dynamic between providers and managed care organizations, enhancing the ability of healthcare professionals to navigate their contractual relationships without undue pressure.
Summary
House Bill 1140 aims to amend existing state regulations concerning managed care organizations and their provider contracts. The bill specifically prohibits certain clauses that can be detrimental to healthcare providers. Specifically, it restricts managed care organizations from requiring healthcare providers to offer services under all health benefit plans they provide and prevents these organizations from terminating contracts with providers for declining to offer those additional services. This legislative move is aimed at ensuring that providers can operate with more autonomy in deciding which services to provide under their agreements with insurance issuers.
Sentiment
The sentiment surrounding HB 1140 appears to be largely favorable among healthcare providers and advocates for patient rights. Many view the bill as a necessary move to prevent overreach by managed care organizations into the provider's business decisions. Supporters argue that this legislation promotes a fairer healthcare system, where providers have the freedom to choose the services they wish to provide without facing undue penalties. The unanimous support shown in the voting points to a strong legislative consensus on the need for reform in this area.
Contention
While there seems to be broad support for HB 1140, the contention arises around the operational specifics and the logistics of enforcement. Critics may voice concerns regarding how such provisions would be monitored and the potential implications for patient care if providers opt out of certain health benefit plans. Additionally, managed care organizations might argue that the bill restricts their ability to structure networks effectively, thereby complicating their operations in delivering comprehensive care.
Provides relative to disclosure and remittance of revenues in excess of certain contractual amounts in certain circumstances for certain contractors with the state's Office of Group Benefits (EN SEE FISC NOTE SG RV)