This bill amends existing laws regarding the relationships between health carriers and contracting providers, specifically focusing on the adequacy of provider networks and the negotiation processes for contracts. It requires the insurance commissioner to assess whether proposed and existing provider networks include a sufficient number of contracted providers across various medical specialties, including behavioral health emergency services starting January 1, 2023. Additionally, the bill introduces new requirements for health carriers when submitting alternate access delivery requests, ensuring that enrollees do not incur higher costs and that carriers demonstrate good faith efforts to contract with providers.

Furthermore, the bill mandates that health carriers must offer providers a meaningful opportunity to negotiate contract terms in good faith before entering into or renewing contracts. It prohibits certain practices, such as all-or-nothing clauses and requiring providers to accept discounted rates under other contracts. The bill also stipulates that any updates regarding contracts and payment policies must be communicated in a manner that does not require access to secure websites. The provisions of this act will take effect on January 1, 2027, and the insurance commissioner is authorized to adopt necessary rules for implementation.

Statutes affected:
Original Bill: 48.49.135