Bill > H1931

This bill proposes changes to how certain hospitals are treated under public health and insurance regulations. Specifically, it aims to ensure that "disproportionate share hospitals," which are facilities serving a high number of low-income or uninsured patients, receive reimbursement rates that cover their actual costs of providing care. Furthermore, the bill seeks to classify any "geographically isolated hospital" that offers inpatient and outpatient mental health services as a disproportionate share hospital. In the context of insurance, the bill allows the commissioner of insurance to consider various factors when assessing if an insurance plan has enough providers to meet member needs, including the location of providers and members, the variety of services offered, and benefits for members with extraordinary medical needs. Crucially, for insurance plans with different provider tiers, the bill mandates that non-profit geographically isolated hospitals with a relatively low cost of services be placed in the highest tier and required to be included in limited network plans for individuals living or working in their service areas.