Substitute Bill No. 983 is designed to prevent anticompetitive practices in health care contracts, effective January 1, 2024. It prohibits clauses such as "all-or-nothing," "anti-steering," "anti-tiering," and "gag" clauses that restrict competition and transparency. The bill defines relevant terms like "health benefit plan," "health care provider," "health carrier," and "health plan administrator." Enforcement of these provisions is the exclusive responsibility of the Attorney General, who, from July 1, 2024, to December 31, 2024, must issue a notice of violation before taking action, allowing for a 60-day resolution period. Violations are considered unfair trade practices, but do not allow for private legal action. The bill also includes additional definitions and elaborations on terms related to enforcement.

Furthermore, the bill sets a cap on out-of-network healthcare costs at 150% of the Medicare reimbursement rate for the same service in the same geographic area, and requires health care providers to comply with this limit. Health benefit plans must pass savings from reduced provider payments to consumers. Hospitals in rural towns and federally qualified health centers are exempt from these provisions. The Office of Health Strategy is tasked with collecting information for hospital price transparency and monitoring compliance, with an obligation to report annually to the General Assembly. The Office has the authority to adopt regulations, adjust cost limits, and impose civil penalties for noncompliance. The act, which includes procedures for violations and hearings, as well as compliance audits, will take effect on January 1, 2024, and amends new sections of the law.