HB 5018 Summary

• Establishes an Office of Health Strategy within the Department of Public Health to develop comprehensive health care cost containment strategies, set annual cost growth benchmarks, and monitor health care delivery and payment models.

• Requires the executive director to set annual health care cost growth benchmarks and a primary care spending target of 10% of total health care expenditures by January 1, 2025, with public hearings to review actual spending against benchmarks.

• Creates a performance improvement plan requirement for health care entities and payers that exceed the annual cost growth benchmark, subject to review, approval, and enforcement by the executive director.

• Establishes a Canadian legend drug importation program under the Commissioner of Consumer Protection, allowing safe importation of prescription drugs from Canada to reduce costs, contingent on federal approval under 21 USC 384.

• Implements strict minimum attachment point requirements for medical stop-loss insurance policies ($20,000 per employee effective January 1, 2021) and regulates "lasering" practices that discriminate against high-cost individuals.