This bill requires that, for health insurance plans issued or renewed on or after January
1, 2026, compensation provisions in a contract between an individual practice that is not affiliated with a hospital or a group practice up to 25 members that is not affiliated with a
45 hospital and a health insurance carrier to provide health care services to enrollees of a health
46 insurance plan must include an increase in compensation for health care services from the
47 prior year that reflects increases in the Consumer Price Index for All Urban Consumers,
48 CPI-U, over the previous year, as compiled by the United States Department of Labor,
49 Bureau of Labor Statistics. This bill prohibits a health insurance carrier offering a health
50 insurance plan from altering contractual reimbursement to an individual practice that is not
51 affiliated with a hospital or a group practice up to 25 members that is not affiliated with a
52 hospital during 2025 to reduce the baseline reimbursement for the purpose of reducing the
53 required compensation increase. The bill also prohibits a health insurance carrier from
54 reducing fees for services covered under a contract with an individual practice that is not
55 affiliated with a hospital or a group practice up to 25 members that is not affiliated with a
56 hospital for any reason other than to reflect changes to the national relative value unit
57 standards determined by the federal Department of Health and Human Services, Centers
58 for Medicare and Medicaid Services.