HB914 Summary: Health Insurance Network Access and Adequacy

• Establishes network adequacy requirements for health carriers offering fully insured network plans, requiring sufficient numbers and types of providers to ensure accessible health care services without unreasonable travel or delay.

• Requires health carriers to file access plans with the insurance commissioner detailing network composition, provider selection criteria, coordination of care procedures, and processes for ensuring network sufficiency before offering new network plans.

• Mandates health carriers establish processes allowing covered persons to access non-participating providers at in-network cost-sharing levels when the carrier lacks available or accessible participating providers for needed services.

• Requires health carriers to provide 60 days' written notice before removing or accepting a provider's departure from the network, with continuity of care procedures for patients in active treatment, pregnant patients, or those with serious acute conditions.

• Imposes requirements on provider-health carrier contracts including hold-harmless provisions protecting patients from balance billing, restrictions on payment-based inducements to limit care, and compliance standards enforced by the insurance commissioner with penalties for violations.