The bill mandates the Health Care Authority to conduct regional commercial insurance market assessments every two years, starting July 1, 2026. These assessments will determine the average commercial insurance reimbursement rates for health care services in neighboring states—Arizona, Colorado, Utah, Oklahoma, and Texas—that are covered by New Mexico's Medicaid program. Additionally, the bill stipulates that the Medicaid reimbursement rate for these services will be set at either 200% of the Medicare reimbursement rate or the regional average commercial insurance reimbursement rate, whichever is higher.

Furthermore, the bill requires that at least 75% of any increase in Medicaid reimbursement revenue received by health care entities must be allocated towards increasing compensation for health care workers or hiring additional staff who directly interact with patients. The legislation defines "health care entity" broadly to include various licensed providers, such as hospitals and clinics, and clarifies the definitions of Medicaid and Medicare as they relate to the federal Social Security Act.