This bill, designated as HB 705, introduces new requirements for health plans under the Managed Care Law to enhance transparency in the pricing of covered items and services. It establishes a new subdivision titled "Transparency in Coverage," which includes key definitions such as "billed charge," "billing code," "negotiated rate," and "historical net price." Health plans are mandated to disclose specific pricing information, including in-network provider rates, out-of-network allowed amounts, and historical net prices for prescription drugs. This information must be made available in three machine-readable files on the health plan's website, ensuring regular updates and public accessibility. The bill also requires health plans to disclose derived amounts if they do not utilize negotiated rates, thereby ensuring consumers have access to relevant pricing information.

Furthermore, the bill outlines the responsibilities of the insurance department's commissioner to standardize and compare pricing information across health plans in accordance with federal guidelines. Health plans are required to update their pricing files monthly and may delegate reporting responsibilities to third parties while remaining accountable for compliance. Notably, the bill stipulates that data related to claims involving fewer than 20 different payments must be omitted to protect privacy. The provisions of this bill will take effect for plan years starting on or after January 1, 2026, and its implementation is contingent upon the finalization of federal guidance under Presidential Executive Order 14221.