Bill > A03659

This bill prohibits insurers or health maintenance organizations (HMOs) that offer managed care or comprehensive policies with provider networks from including certain requirements in their contracts with healthcare providers. These prohibited requirements include: (1) requiring the insurer to include all members of a provider group in its network; (2) requiring the insurer to place all members of a provider group in the same network tier; (3) requiring the insurer to include all members of a provider group in all of its products; (4) prohibiting the insurer from using benefit designs to encourage members to seek services from higher-value providers; and (5) containing most-favored-nation provisions. The bill also prohibits contracts that limit the ability of the insurer or provider to disclose fee information to insureds. Any existing contracts with these prohibited provisions will be null and void as of January 1, 2022, though the remaining contract terms will remain in effect.