Health Care Contract Hospital System Carriers Providers

The bill prohibits a health system from requiring a carrier, as a condition of a contract for the delivery of health care services, to:

• Contract with every hospital or other facility within the health system;
• Agree to provide the same reimbursement rates at each hospital or other facility within the health system; or
• Contract with all of the hospitals in the health system in order to access a lower reimbursement rate than is otherwise offered by the health system.

The bill also precludes a hospital or health system from, as a condition of a contract:

• Prohibiting a carrier from contracting with any other hospital or health system;
• Prohibiting a health care provider or provider group from contracting with any other hospital or health system.

The bill states that if, pursuant to the terms of employment or certain contract terms, a health care provider is prohibited from referring a patient to a health care provider outside the health system in which the referring provider is employed or contracted, the health care provider must disclose this restriction to any patient who the health care provider refers to another health care provider within the same health system.

The bill makes necessary conforming amendments.

(Note: This summary applies to this bill as introduced.)