SB 1385 Summary

• The Employee Group Insurance Department of the Office of Management and Enterprise Services shall contract with a vendor to operate a HIPAA-compliant mutual accountability incentive program that provides financial rewards to both healthcare providers and patients for adherence to evidence-based treatment guidelines.

• The pilot project shall include a cohort study with a minimum of 15,000 beneficiaries designated as the intervention group, compared against a control group of non-participating beneficiaries, over a three-year period to measure cost containment effectiveness.

• An oversight committee consisting of five members (two appointed by the Speaker of the House, two by the President Pro Tempore of the Senate, and one by the Governor) shall have administrative authority over the pilot project and shall dissolve after final report approval.

• The oversight committee is empowered to direct data sharing between the Department and vendor, require annual performance reports, select an independent evaluator to assess program cost containment capabilities, and submit the final evaluation report to the Governor and legislative leaders.

• The act becomes effective November 1, 2016.