MA H1192

Adds Section 28 to Chapter 176O requiring health insurance carriers to use uniform, network-wide expense data when establishing alternative payment arrangements, rather than provider-specific prices or historic spending from select providers

Permits carriers to consider patient population characteristics including age, acuity, social determinants of health, and behavioral health needs when setting alternative payment arrangements

Allows alternative payment arrangements to include adjustments for claims processing, administrative costs, and incentive payments tied to quality measures or outcomes

Requires carriers to file data on their alternative payment arrangements with the Center for Health Information and Analysis for compliance verification

Violations of the non-discrimination requirements or reporting requirements constitute violations of Chapter 93A (the Massachusetts Consumer Protection Act)