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Under this bill, effective July 1, 2015, a private act hospital may not enter into or renew a provider network or contract with a hospital or medical service corporation that contains an exclusive provider provision. An exclusive provider provision contained in a provider network agreement between a private act hospital and a hospital and medical service corporation shall be void and unenforceable. This bill further provides that a private act hospital may not enter into or renew a provider network contract with a health insurer that contains an exclusive provider provision. Effective January 1, 2016, an exclusive provider provision contained in a provider network contract between a private act hospital and a health insurer would be void and unenforceable. The above provisions would not apply to any agreement between a private act hospital and a provider network, the majority ownership of which is owned by the private act hospital. This bill is only applicable to private act hospitals located in counties in which the private act hospital has 55 percent or more of the total nonpsychiatric hospital discharges within the county during any one calendar year, but will not apply to a private act hospital that is the only hospital provider located in the county in which the private act hospital has its principal operations. This bill defines "exclusive provider provision" as a provision in a provider network contract between an insurer and a private act hospital that prohibits the insurer from including in the provider network any other hospital located in the same county as the private act hospital. This bill provides that it does not: (1) Affect the antitrust immunity granted to private act hospitals under this section; (2) Affect the ability of a private act hospital to negotiate reimbursement and other terms of a provider network agreement based on anticipated volume and types of patients; (3) Otherwise affect the terms and conditions of insurer provider network agreements; (4) Require any hospital to be a participant in an insurer's provider network; (5) Require an insurer to enter into a provider contract agreement with any particular hospital; or (6) Affect the discretion of an insurer as to how it configures and administers its provider networks.
Votes for Bill HB2916 by the House are not available.
Votes for Bill SB2903 by the Senate are not available.