The bill amends Section 27-20.9-3 of the General Laws regarding contracts with healthcare providers. It establishes that health insurers cannot require physicians to participate in any financial or reimbursement incentive programs, specifically "capitation" or any "alternative payment model," as a condition for contracting. These models are defined as those that create financial incentives for physicians to limit medically necessary care or to selectively retain low-need patients while potentially excluding high-need patients.

The bill removes previous requirements that such incentive programs must adhere to principles and guidelines endorsed by recognized organizations, including the national quality forum and the AQA Alliance. Instead, it focuses on prohibiting any financial incentives that could compromise patient care. The act is set to take effect immediately upon passage.

Statutes affected:
470: 27-20.9-3