HB 1433 – Virginia

Status: Inactive / Dead
Year Introduced: 2018
Link: https://lis.virginia.gov/cgi-bin/legp604.exe?181+sum+HB1433

Health care provider panels; vertically integrated carriers; public hospitals. Requires any vertically integrated carrier, which is a health insurer or other carrier that owns an interest in an acute care hospital facility, to offer to every public hospital the ability to participate in the provider panels or networks established for each of the carrier’s policies, products, and plans. The measure also requires any contract by which a public hospital participates in a vertically integrated carrier’s provider panel or network to obligate the carrier to reimburse the public hospital for a covered health care service at a rate that is not less than the fair and nondiscriminatory rate. The measure establishes the methodology for determining a fair and nondiscriminatory rate, which is based on the same percentage in excess of the Medicare rate that the carrier pays to the acute care hospital facilities in which it owns an interest. The measure provides a procedure by which a public hospital may dispute a vertically integrated carrier’s calculation of a fair and nondiscriminatory rate and authorizes a public hospital to bring a civil action against such a carrier to recover any underpayment or for injunctive or declaratory relief.

Return to Database Search

© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

Associated Litigation:

No items found