General Assembly Raised Bill No. 7115 proposes significant revisions to the Health Care Cost Growth Benchmark Program, particularly focusing on the reporting requirements for payers of self-funded employee health plans. Key insertions include a mandate for payers to provide employers with an opt-in form for submitting their health plan data, which must be accessible on the Office of Health Strategy's website. Additionally, payers are required to report aggregated data annually to the commissioner, including lists of employers who opted in or out, along with a certification of their efforts to distribute the opt-in form. The bill also stipulates that no fees can be charged to employers for including their self-funded data in the payer's reporting. The existing Section 19a-754h is repealed and replaced, with the new provisions set to take effect on October 1, 2025.

Moreover, the bill enhances the oversight of health care quality benchmarks and expenditures by requiring the Commissioner of Health Strategy to prepare and publish an annual report on health care quality benchmarks starting March 31, 2024. It introduces a penalty of up to ten dollars per covered individual for payers who fail to provide the required opt-in forms. The bill also repeals and substitutes language in section 19a-754j, establishing a framework for annual public hearings to assess health care expenditure growth against benchmarks, requiring participation from significant contributors to health care costs. Additionally, the commissioner is tasked with submitting a report by January 1, 2026, analyzing the effectiveness of health care benchmark performance improvement plans. Overall, the bill aims to improve transparency and accountability in health care spending while exploring effective cost management strategies.

Statutes affected:
Raised Bill: