Idaho introduced a number of bills in the 2018 legislative session aimed at promoting price transparency and controlling healthcare costs. While most failed to pass, the legislature passed the Idaho Free Market Insurance Act (SB 1288), which allows individuals to lower their health insurance costs by making available competitive health plans from out-of-state insurance companies. The state also passed SB 339, which amends the Pharmacy Practice Act to enable lower cost substitution for prescription drugs that are in the same therapeutic class. In the 2016 legislative term, Idaho proposed but did not pass healthcare transparency legislation that would have required health insurers on the state’s ACA exchange to disclose a range of specific information.
The state currently has a ban on most favored nation clauses. A most favored nations clause is an agreement between a payer (such as an insurance company) and a provider that typically requires a provider to give the payer the lowest rate that it gives to any other comparable payer, which can be anticompetitive as it encourages oligopolistic pricing by large payers and increases barriers for new entrants.
Idaho has also been active in antitrust enforcement, as the Idaho Attorney General joined with the FTC to challenge the acquisition of Idaho’s largest independent, multi-specialty physician group by St. Luke’s Health System. In that case, the Ninth Circuit held that the acquisition violated Section 7 of the Clayton Act and the Idaho Competition Act.
The State Database
The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.
LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates.
LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.
Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.