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.

Additionally, the bill removes previous requirements for incentive programs to adhere to principles and guidelines endorsed by various quality forums and alliances. This change aims to protect physicians from being compelled into participation in programs that may compromise patient care by incentivizing the limitation of necessary medical services. The act will take effect immediately upon passage.

Statutes affected:
5851: 27-20.9-3