SB 932 Summary

• Requires any person intending to merge with, consolidate, acquire, or control a health care service plan to obtain prior approval from the Department of Managed Health Care director and hold a public hearing.

• Mandates the director find that proposed transactions do not adversely affect competition, provide short and long-term benefits to patients and subscribers, and do not jeopardize financial stability or access to care before approval.

• Prohibits health care service plans, health insurers, and payors from requiring contracted providers to include affiliated providers in their networks as a condition of participation or from restricting tiered network offerings, effective January 1, 2017.

• Voids and makes unenforceable any contract provisions entered into on or after January 1, 2017 that violate the prohibited terms, including gag clauses that prevent rate disclosure and requirements for binding arbitration on non-breach disputes.

• Allows the director to grant conditional approval for transactions if parties commit to preventing adverse impacts on competition, health care costs, access, and quality of care.