Bill targets anticompetitive clauses in health care contracts

What does this do?

This bill would make certain contract clauses illegal in health care and insurance agreements. Banned clauses include ones that block insurers from steering patients to cheaper or better providers, force plans to use a provider's affiliated facilities, set prices for those facilities, or stop other plans from negotiating lower prices. Some exceptions apply for HMOs with exclusive physician groups and certain value-based care networks like accountable care organizations or centers of excellence.

Who does it affect?

The rules would apply to insurance companies, employer-sponsored health plans, hospitals, doctor networks, and third-party administrators. Federal agencies would have one year to write the detailed rules, and the requirements would cover contracts signed, changed, or renewed starting 18 months after the law passes.

Why does it matter?

Without these contract restrictions, health plans may have less freedom to direct patients toward lower-cost or higher-quality providers. The bill changes what employers and insurers can legally agree to when they sign contracts with health care providers.

Where does it stand?