Bill > S2217

This bill aims to address commercial insurance price variation for underpaid acute hospitals and promote access to high-value acute hospital care in the Commonwealth. It amends several chapters of the General Laws to require that the subscriber contracts, rates, and evidence of coverage for health benefit plans be subject to the disapproval of the Commissioner of Insurance. Specifically, the bill considers health benefit plan rates filed with the Division of Insurance as presumptively disapproved if the carrier's network provider reimbursement rates, including rates and targets within alternative payment contracts, do not reimburse acute hospitals at or greater than a minimum of 90 percent of the carrier's statewide average commercial relative price calculated separately for acute hospital inpatient and outpatient services. Carriers are required to annually certify and provide hospital-specific evidence to the Division of Insurance that each acute hospital's rates meet this minimum threshold.

Health and Social Services

https://malegislature.gov/Bills/191/S2217