The bill S.43 proposes the implementation of a reference-based pricing program for inpatient and outpatient hospital services within the State employees health plan, set to begin in 2026. It aims to limit the growth rate of premiums in the health plan to align with medical inflation rates and allows school employers the option to include their employees in the plan. The bill amends current law to clarify the definition of "employees" to include school employees at the discretion of school employers and establishes a requirement for the Secretary of Administration to ensure the utilization of the reference-based pricing program.

Additionally, the bill mandates that the Secretary of Administration report annually to the General Assembly on the impact of the reference-based pricing program on the costs associated with group hospital-surgical-medical expense insurance for State employees. The effective date for the provisions of this act is set for January 1, 2026, with the first report due by March 15, 2027.

Statutes affected:
As Introduced: 3-631