Bill > H820

This bill aims to reform how healthcare spending is measured and controlled by establishing new rules for determining "excessive spending" and limiting rate increases for healthcare providers and organizations. Specifically, it modifies existing laws to define excessive spending for providers and provider organizations as the increase in their total healthcare expenditures exceeding a calculation based on the "cost growth benchmark" (a measure of how much healthcare costs are expected to rise) divided by their "relative price" (how their prices compare to the average). The bill also adds a new section to prevent insurance carriers from granting annual rate increases to providers and provider organizations that exceed this same cost growth benchmark divided by their relative price, as reported by the Center for Health Information and Analysis (CHIA), a state agency that collects and analyzes health care data. Furthermore, it mandates that carriers limit the growth of payments to high-cost providers, as identified by CHIA, to rates no higher than the cost growth benchmark divided by the provider's average relative price across all health care networks. The commissioner is tasked with creating regulations to implement these changes.