HB 6785 Summary

• Creates a framework for "health care collaboratives" comprised of physicians, chiropractors, podiatrists, naturopaths, and optometrists from separate firms to negotiate collectively with health plans regarding compensation and terms of service.

• Requires prospective health care collaboratives to obtain a preliminary certificate of public advantage from the Office of the Healthcare Advocate before negotiating with health plans, demonstrating they will incentivize quality over volume or implement programs to improve practice efficiency.

• Establishes a mediation and fact-finding process for disputes between health care collaboratives and health plans, with the Healthcare Advocate authorized to order resolution if negotiations reach impasse; prohibits health plans from refusing good faith negotiation.

• Requires the Healthcare Advocate to review and approve final agreements between health care collaboratives and health plans based on reasonableness of fees and quality of services before issuing a certificate of public advantage; charges prospective collaboratives $1,000 administrative fee.

• Provides ongoing monitoring and annual reporting requirements; allows Healthcare Advocate to revoke certificates for non-compliance; all effective October 1, 2015.