This bill addresses health care costs by modifying several existing laws to enhance oversight and control of health care spending. It empowers the Health Policy Commission to require performance improvement plans from health care entities that exceed spending benchmarks or fail to submit proper data, and introduces significant penalties for non-compliance, including civil penalties up to $750,000 for repeated violations. The bill allows the commission to block material change notices, notify the Department of Public Health about non-compliance, and deposit penalties into a Healthcare Payment Reform Fund. Additionally, the bill requires the Center for Health Information and Analysis to perform ongoing analysis of health care spending, identifying entities with excessive spending or data submission issues, and confidentially refer them to the Health Policy Commission. The legislation also modifies rate review processes for various health care entities, giving the commissioner more authority to approve, modify, or disapprove rates that are considered excessive, inadequate, or unfairly discriminatory. These changes aim to create more transparency, accountability, and control over health care costs in the state.