Health care provider panels; vertically integrated carriers, providers.

SB 867 Health care provider panels; vertically integrated carriers, providers

Virginia 2021 Regular Session

Health care provider panels; vertically integrated carriers, providers.
SB-867


About SB-867

Health care provider panels; vertically integrated carriers; providers. Requires any vertically integrated carrier to offer participation in each 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 state and federal government benefit programs, to every provider in the Commonwealth 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; providers. Requires any vertically integrated carrier to offer participation in each 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 state and federal government benefit programs, to every provider in the Commonwealth 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.

  

Bill Texts

Prefiled 01/08/2020

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Sponsors (3)

Votes

Senate: Continued to 2021 in Commerce and Labor (11-Y 3-N 1-A)

02/09/2020

Yeas: 11 | Nays: 3
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History

Left In Commerce And Labor

12/04/2020

Continued To 2021 In Commerce And Labor (11-y 3-n 1-a)

02/09/2020

Prefiled And Ordered Printed; Offered 01/08/20 20104856d

01/08/2020

Referred To Committee On Commerce And Labor

01/08/2020