Bill > SF2111

This bill allows health carriers to offer reference-based pricing health plans in the individual, small, and large group markets. These plans would reimburse providers based on a percentage of the most recent Medicare reimbursement rates, rather than negotiated rates. Providers who agree to participate in these plans must accept the reimbursement rate as payment in full. The bill also exempts these plans from certain geographic and network adequacy requirements if the reimbursement rate is at least 120% of the Medicare rate and the plan is offered statewide. Providers are not required to participate in these plans, and health carriers cannot make participation a condition of participating in other plans.