SB 474

Abstract

Health care provider panels; vertically integrated carriers; public hospitals. Requires any vertically integratedcarrier to offer to every public hospital participation in each providerpanel or network established for each of the vertically integratedcarrier's policies, products, and plans, including all policies,products, and plans offered to individuals, employers, and enrolleesin state and federal government benefit programs. The measure requiresthat the offered participation (i) be without any adverse tieringor other financial incentives that may discourage enrollees from utilizing the services of the public hospital and (ii) include allservices offered by the public hospital and any other entity owned,operated, or controlled by the public hospital. The bill defines"vertically integrated carrier" as a health insurer or other carrierthat owns an interest in, is owned by, or is under common ownershipor control with an acute care hospital facility, excluding an entitythat is under the ultimate control of or under common control witha public hospital.