House Bill 627 - Summary

• Directs the Division of Medicaid to establish a five-year pilot program beginning January 1, 2020, to evaluate a provider-sponsored health plan as a participant in the state's managed care program.

• Requires any provider-sponsored health plan selected for the pilot program to be established and duly licensed by the Department of Insurance on the effective date of the act.

• Provider-sponsored health plan must cover at least 20% of the population enrolled in the managed care program during the five-year pilot period.

• Mandates the Division of Medicaid to submit annual reports to the House and Senate Medicaid Committee Chairs beginning in December 2021, comparing the provider-sponsored health plan's performance to other plans in the areas of health outcomes, administrative costs, provider satisfaction, and provider participation.