House Bill No. 7116, titled "An Act Concerning Insurance Accountability and Transparency," seeks to improve the transparency and accountability of health care contracts by prohibiting certain restrictive clauses. The bill repeals Section 38a-477i and introduces new definitions for clauses such as "all-or-nothing," "anti-steering," "anti-tiering," "gag," and a "revenue neutrality clause." These clauses are defined as provisions that restrict health carriers or health plan administrators from negotiating or disclosing information about health care services. The bill specifically prohibits the inclusion of these clauses in health care contracts that are entered into, amended, or renewed after July 1, 2025, rendering any such clauses null and void. Additionally, it amends Section 19a-754f to clarify definitions related to drug manufacturers and health care benchmarks, updating the effective date from July 1, 2024, to July 1, 2025, while ensuring that existing privacy protections under federal laws, such as HIPAA, remain intact.

Furthermore, the bill mandates the Office of Health Strategy (OHS) to submit aggregated payer data to the Insurance Commissioner annually, starting March 1, 2026, to calculate total health care expenditures and primary care spending targets. The Insurance Commissioner is authorized to engage independent auditors to review this data for accuracy and reliability. The prohibition of revenue neutrality clauses, which require indemnification of providers by health carriers, will take effect on July 1, 2025, while other provisions will be effective upon passage. Overall, the bill aims to create a more equitable and transparent health care system by eliminating restrictive contractual provisions that may hinder competition and access to information.

Statutes affected:
Raised Bill:
INS Joint Favorable:
File No. 409: