Requires carriers to disclose selection standards for placement of health care providers in tiered health benefits plan network; establishes oversight monitor to review compliance.
Impact
The enactment of S1430 is expected to have a significant impact on state health laws surrounding insurance and provider networks. By requiring comprehensive reporting on how healthcare providers are evaluated and selected for these networks, the bill promotes accountability among insurance carriers. The established oversight monitor, which will review compliance and ensure that the disclosures are accurate and timely, serves as a regulatory checkpoint that could enhance the overall quality of patient care provided under tiered health plans.
Summary
Senate Bill 1430 (S1430) is a legislative proposal designed to enhance transparency within tiered health benefit plans by mandating health insurance carriers to disclose specific selection standards used to evaluate and place healthcare providers in tiered networks. A tiered network is characterized as a managed care plan where providers are arranged in levels or tiers based on varying reimbursement and cost-sharing structures. This bill aims to improve consumer knowledge and confidence in the quality of care provided under these plans.
Contention
While the bill has gained support for its potential to improve transparency and patient safety, some stakeholders have expressed concerns about the compliance burden it could impose on insurance carriers. Critics argue that the extensive requirements for data disclosure may lead to increased operational costs for carriers, which could ultimately be passed on to consumers. Furthermore, there may be apprehensions regarding the effectiveness of the oversight monitor and whether it can ensure that the information provided is both accurate and meaningful to consumers in making informed healthcare choices.
Relating to the provision of health and human services by the Department of Family and Protective Services and the Health and Human Services Commission.