This bill amends the Managed Care Law to establish new notice requirements for health carriers regarding changes to contracts with participating providers and facilities. Specifically, it mandates that health carriers provide a 60-day notice for proposed contract changes, limited to four times per calendar year on specified dates (January 1, April 1, July 1, and October 1). Exceptions to this requirement include mutual agreement to waive the notice, changes mandated by state or federal regulations, or updates due to changes in procedural terminology codes. Additionally, health carriers must provide both the original and revised contract documents, clearly indicating changes through underlining and strikethroughs.

Furthermore, if the changes result in an aggregate reimbursement impact exceeding $500,000 per year across all participating providers, the carrier is required to provide a good faith estimate of the financial impact to each provider and submit this information to the commissioner of insurance for public disclosure. The bill will take effect 60 days after its passage and is projected to have a fiscal impact of less than $10,000 annually from 2025 to 2028.

Statutes affected:
Introduced: 420-J:8
SB126 text: 420-J:8