House Bill No. 7116 seeks to improve accountability and transparency in health care contracts by prohibiting specific clauses that limit competition and transparency. The bill introduces new definitions for terms such as "all-or-nothing clause," "anti-steering clause," "anti-tiering clause," "gag clause," and "revenue neutrality clause," which will be banned in contracts between health care providers, health carriers, and health plan administrators starting July 1, 2025. Any contracts containing these prohibited clauses will be considered null and void, although other provisions within the contracts will remain effective. The bill also repeals and replaces certain sections of existing statutes to clarify the roles of entities like "drug manufacturers" and "payers," while ensuring that patient privacy protections under federal law are maintained.

Furthermore, the bill mandates the Office of Health Strategy (OHS) to provide aggregated payer data to the Insurance Commissioner annually, beginning March 1, 2026. This data will be utilized to assess total health care expenditures and establish primary care spending targets, with the Insurance Commissioner authorized to employ independent auditors for data verification. The prohibition of revenue neutrality clauses and the new reporting requirements reflect a significant shift towards promoting fair practices in health care contracting and enhancing consumer access to information regarding health care services and costs.

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