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. Additionally, the bill allows school employers the option to include their employees in the State employees health plan.

To facilitate these changes, the bill amends current law by redefining the term "employees" to include school employees at the discretion of school employers. It also mandates that the Secretary of Administration ensure the utilization of a reference-based pricing program for hospital services, while limiting the annual premium growth to the percentage change in the Consumer Price Index for medical care in the Northeast. Furthermore, the Secretary is required to report annually to the General Assembly on the impact of the reference-based pricing program on insurance costs for State employees. The act is set to take effect on January 1, 2026, with the first report due by March 15, 2027.

Statutes affected:
As Introduced: 3-631