Healthy Competition for Better Care Act
If enacted, HB 3120 would significantly amend Section 2799A–9 of the Public Health Service Act, making it illegal for group health plans and health insurance issuers to enter into agreements that limit their ability to divert patients to more efficient or cost-effective providers. This legislation would empower health plans to make more flexible decisions regarding network design, specifically in steering enrollees towards preferred providers and achieving various quality or cost initiatives. Additionally, the act also preserves existing privacy laws, ensuring that patient data protection remains intact amidst these changes.
House Bill 3120, titled the 'Healthy Competition for Better Care Act', primarily seeks to eliminate anticompetitive clauses in facility and insurance contracts that restrict patients' access to higher quality, lower cost healthcare services. The bill aims to foster a more competitive environment in the healthcare sector by enabling health plans and insurance issuers to direct and incentivize patients to utilize specific healthcare providers without undue restrictions. By prohibiting such terms, the bill hopes to encourage better patient outcomes and, ultimately, lower healthcare costs.
While proponents advocate for the increased accessibility and affordability of healthcare, concerns may arise regarding the compliance of these changes with existing antitrust laws. The bill includes provisions that require self-insured plans to be transparent about restrictive terms they might inadvertently adopt from their agreements with other providers. Critics argue that this could lead to a decrease in the overall quality of care if not managed cautiously, as the pressure to funnel patients towards select providers could sacrifice the diversity and choice that patients currently enjoy.