SECTION 1. Section 18 of Chapter 12C of the general laws is hereby amended by adding the following after the first sentence:-
For providers and provider organizations, excessive spending shall be determined based on the increase in the provider or provider organization’s total health care expenditures in excess of: (a) the cost growth benchmark divided by (b) the provider or the provider organization’s relative price.
SECTION 2. Chapter 176O of the general laws is hereby amended by adding a new Section 28 as follows:
Section 28. (a) Notwithstanding any other general or special law to the contrary, no carrier shall grant a provider or provider organization an annual increase in rates that exceeds the cost growth benchmark established in section 9 of chapter 6D divided by the provider or provider organization’s relative price as reported by the center for health information and analysis. The commissioner shall adopt regulations to carry out this section.
(b) The division shall by regulation require carriers limit the growth of payments to high cost providers, as determined by the center for health information and analysis pursuant to section 18 of chapter 12C, to rates at or below the rate of increase of the cost growth benchmark divided by that provider’s or the provider organization’s average relative price for all health care networks.
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