Bill > H7862

This bill, amending the "Healthcare Accessibility and Quality Assurance Act," prohibits a healthcare entity, which includes its affiliates, subsidiaries, or vendors that offer health plans in the state, from unilaterally changing, amending, or reinterpreting any significant part of a contract with a healthcare provider while that contract is still active. Important terms and conditions are broadly defined to include changes to how providers are paid (reimbursement methodologies or fee schedules), payment timelines, carrier policies, what services are covered, requirements for prior approval or medical necessity, quality standards, credentialing, billing, and clinical guidelines. These significant terms also encompass any policies or guidance incorporated into the contract, even if provided electronically. Healthcare entities can only implement changes to these contracts if both parties mutually agree in writing or if the change is mandated by state or federal law; otherwise, any non-legally required changes can only take effect at the contract's renewal, provided the healthcare entity gives at least 90 days' written notice of the proposed changes beforehand.

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