Healthy Competition for Better Care Act

Key Points

• The bill bans contract clauses that prevent health plans from steering patients toward higher-quality or lower-cost providers. Insurance companies could no longer be locked into agreements that block them from directing members to better-value care options.
• Hospitals and health systems can no longer force insurers into "all-or-nothing" deals that require them to contract with affiliated facilities or agree to payment rates for affiliates not part of the original agreement.
• The bill prohibits "most favored nation" clauses that prevent other health plans from negotiating lower rates for the same services, removing a major barrier to price competition.
• Value-based care models like HMOs, accountable care organizations, and centers of excellence are explicitly exempted from the anti-steering ban, preserving established integrated care arrangements.
• States can grandfather certain pre-existing contracts executed around June 2019 through December 2020 for up to 10 years, if the state determines those deals are unlikely to significantly reduce competition.
• The new rules would apply to contracts entered into, amended, or renewed 18 months after the bill becomes law, and federal agencies must issue implementing regulations within one year of enactment.

Votes

No votes have been recorded for this legislation yet.