Budget Amendment ID: FY2017-S4-626

EHS 626

Rate Banding

Mr. Humason moved that the proposed new text be amended by inserting that the end thereof the following new section:-

SECTION XX. Chapter 176O is hereby amended by adding after section 27 thereof the following section:-

Section 28. Notwithstanding any law to the contrary, no carrier or health care provider shall enter or renew a contract or agreement on or after October 1, 2016 under which the carrier agrees to pay the health care provider at a rate that is not in conformity with the standards as forth in (a) and (b) below.

(a) No carrier or health care provider shall enter or renew a contract or agreement on or after October 1, 2016 under which the health care provider is reimbursed at a rate that is 20% above the mean for the carrier-specific price or 10% below the mean for the carrier-specific price.

(b) Contracts or agreements with providers whose contract term period extends beyond December 31, 2016 shall be amended by March 31, 2017 to comply with the rate banding policy (a) above.