The Healthy Competition for Better Care Act would ban health insurers and group health plans from using restrictive contract terms that prevent them from steering patients to lower-cost or higher-quality providers. Specifically, the bill prohibits agreements that restrict insurers from directing enrollees to other doctors, offering incentives to use certain providers, requiring insurers to sign contracts with provider affiliates as a condition of doing business, or forcing insurers to accept the same payment rates for affiliate providers. The legislation applies to health insurance companies, employer-sponsored plans, and self-insured group health plans. The bill includes exceptions for certain health maintenance organizations and value-based arrangements like accountable care organizations and exclusive provider networks. The regulations implementing the bill must be completed within one year of enactment, and the new rules would take effect 18 months after passage for new contracts, with existing contracts subject to the requirements at their next renewal or within three years.
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