VA HB1075 | 2023 | Regular Session

Note: Carry Over of previous HB1075

Status

Spectrum: Partisan Bill (Republican 1-0)
Status: Introduced on January 12 2022 - 25% progression, died in committee
Action: 2022-11-22 - Left in Commerce and Energy
Pending: House Commerce and Energy Committee
Text: Latest bill text (Prefiled) [HTML]

Summary

Health care provider panels; vertically integrated carriers; reimbursements to providers. Requires any vertically integrated carrier, upon written request, to offer participation in each requested provider panel or network established for each of the vertically integrated carrier's policies, products, and plans, including all policies, products, and plans offered to individuals, employers, and enrollees in government benefit programs, to the requesting provider under the same terms and conditions that apply to providers under common control with the vertically integrated carrier. The measure requires that the offered participation (i) be without any adverse tiering or other financial incentives that may discourage enrollees from utilizing the services of the provider, (ii) include all sites and services offered by the provider, and (iii) take into account the different characteristics of different providers with regard to the range, nature, cost, and complexity of services offered. The measure prohibits an officer or director of a vertically integrated carrier from simultaneously serving as an officer or director of an entity that owns, operates, manages, or controls an acute care hospital located, in whole or in part, in the Commonwealth. The measure defines "vertically integrated carrier" as a health insurer or other carrier that owns an interest in, is owned by, or is under common ownership or control with an acute care hospital facility, excluding an entity that is under the ultimate control of or under common control with a public hospital. Health care provider panels; vertically integrated carriers; reimbursements to providers. Requires any vertically integrated carrier, upon written request, to offer participation in each requested provider panel or network established for each of the vertically integrated carrier's policies, products, and plans, including all policies, products, and plans offered to individuals, employers, and enrollees in government benefit programs, to the requesting provider under the same terms and conditions that apply to providers under common control with the vertically integrated carrier. The measure requires that the offered participation (i) be without any adverse tiering or other financial incentives that may discourage enrollees from utilizing the services of the provider, (ii) include all sites and services offered by the provider, and (iii) take into account the different characteristics of different providers with regard to the range, nature, cost, and complexity of services offered. The measure prohibits an officer or director of a vertically integrated carrier from simultaneously serving as an officer or director of an entity that owns, operates, manages, or controls an acute care hospital located, in whole or in part, in the Commonwealth. The measure defines "vertically integrated carrier" as a health insurer or other carrier that owns an interest in, is owned by, or is under common ownership or control with an acute care hospital facility, excluding an entity that is under the ultimate control of or under common control with a public hospital.

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Title

Health care provider panels; vertically integrated carriers, reimbursements to providers.

Sponsors


History

DateChamberAction
2022-11-22HouseLeft in Commerce and Energy
2022-02-10HouseContinued to 2023 in Commerce and Energy by voice vote
2022-01-12HouseReferred to Committee on Commerce and Energy
2022-01-12HousePrefiled and ordered printed; offered 01/12/22 22102199D

Same As/Similar To

HB1075 (Carry Over) 2022-02-10 - Continued to 2023 in Commerce and Energy by voice vote

Subjects


Code Citations

ChapterArticleSectionCitation TypeStatute Text
3823407.10(n/a)See Bill Text
3824319(n/a)See Bill Text

Virginia State Sources


Bill Comments

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