Healthy Competition for Better Care Act
Sponsored By: Senator Jon Husted
Introduced
Summary
Ban anticompetitive contract terms that stop plans from steering patients to higher-quality, lower-cost providers. This bill would block agreements that limit a plan or issuer from directing participants to providers or offering incentives to use better or cheaper care.
Show full summary
- Families and patients: Makes it easier for health plans to steer people toward higher-quality, lower-cost providers by preventing provider clauses that block steering or incentives.
- Employers and group health plans: Would bar plans and insurers from signing contracts that restrict plan design, steering, pricing, or incentives and would apply the rule across the Public Health Service Act, the Employee Retirement Income Security Act (ERISA), and the Internal Revenue Code.
- Providers, networks, and states: Preserves exceptions for certain HMOs and value-based networks like accountable care organizations and centers of excellence, and lets States grandfather specified contracts executed on June 19, 2019 and related contracts through December 31, 2020 for up to 10 years.
Regulations would be issued by the relevant federal agencies within defined timelines and the rules would apply to contracts entered into, amended, or renewed 18 months after enactment.
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
More provider choice in health plans
If enacted, the bill would stop group health plans and health insurers from signing contracts that limit steering or incentives to other providers. It would ban clauses that force plans to sign extra affiliate agreements, set payment terms for affiliates not party to the deal, or block other plans from paying lower rates. The bill would define "covered entities" to include providers, provider networks, and third-party administrators that offer access to a provider network. This would apply to contracts entered into, amended, or renewed 18 months after the bill becomes law. States could allow nonapplication for contracts signed on June 19, 2019, and related contracts signed on or before December 31, 2020, for up to 10 years. The bill would exempt certain HMOs and many value-based networks such as exclusive provider networks, accountable care organizations, centers of excellence, and similar arrangements identified by the Secretary.
One-year rule deadline for agencies
If enacted, the bill would require HHS, in consultation with Labor and Treasury, to issue regulations implementing the Public Health Service Act changes within one year of enactment. It would require the Labor Secretary, in consultation with HHS and Treasury, to issue ERISA regulations within one year. It would require the Treasury Secretary, in consultation with HHS and Labor, to issue Internal Revenue Code regulations within one year. Those rules would explain how to apply the new prohibitions on provider contracting terms.
Sponsors & CoSponsors
Sponsor
Jon Husted
OH • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
View on Congress.govTake It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in