Official Text and Analysis.

Beginning January 1, 2022, a contract between a hospital or affiliate hospital and a health carrier may not, directly or indirectly: • set provider compensation agreements or other terms for nonparticipating affiliates of the hospital; • require a health carrier to contract with the hospital's affiliates; • require health carriers to place a hospital or affiliate in an enrollee cost-sharing tier that reflects the lowest or lower enrollee cost-sharing amounts; or • require health carriers to keep the contracts payment rates confidential from any existing or potential payor that is or may become financially responsible for the payments, though these communications may be subject to a reasonable nondisclosure agreemen.

Specifies that: • only for purposes of actions brought by the Office of the Attorney General is a violation of the bill an unfair or deceptive practice in trade or commerce that is an unfair method of competition; and • a certified critical access hospital is not prohibited from negotiating on behalf of a provider or medical group affiliated with the hospital.

(1) Clarifies that a contract between a hospital and a health carrier may not set provider compensation or other terms for affiliates of the hospital that are out of the carrier's network, rather than prohibiting a contract from setting provider compensation agreements or other terms for nonparticipating affiliate. (2) Limits the provision that prohibits a contract between a hospital and a health carrier from requiring the health carrier to contract with a hospital's affiliates, so that prohibition only applies to requiring a health carrier to contract with multiple hospitals owned or controlled by the same single entity. (3) Modifies the exemption for critical access hospitals, so that critical access hospitals may negotiate payment rates and methodologies on behalf of individual health care practitioners and a medical group, rather than providers (which is defined to include health care facilities) and medical groups, and adds independent sole community hospitals to the exemption.