This bill mandates the State Health Benefits Commission and the School Employees Health Benefits Commission to conduct a thorough review of reference-based pricing health benefits models and assess the financial implications of implementing such pricing for the State Health Benefits Program and the School Employees Health Benefits Program. The review will be carried out in consultation with the actuaries and contracted carriers of each program, focusing on identifying specific areas where reference-based pricing can be applied. The bill outlines key areas for evaluation, including anticipated costs and savings, the impact on high-cost medical services, optimal reimbursement amounts, and the legal requirements that would affect the implementation of reference-based pricing.

Furthermore, the bill requires each commission to issue a final report detailing their findings and recommendations within 180 days of the bill's effective date. Additionally, within one year of the bill's enactment, the commissions must implement reference-based pricing for new contracts with carriers, establishing reimbursement limitations based on Medicare rates. Prior to this implementation, each commission is tasked with creating a written report that outlines how reference percentages are determined, expected cost savings, and existing negotiated cost ranges for procedures with each carrier.