An Act To Promote Fairness in Negotiations between Health Insurance Carriers and Health Care Service Providers
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24-A MRSA §4303, sub-§15 is enacted to read:
15. Prohibition on "most favored nation" clauses. A participation agreement between a carrier and a provider may not include a provision, commonly referred to as a "most favored nation" clause, that:
A. Prohibits, or grants the carrier an option to prohibit, the provider from entering into a participation agreement with another carrier to provide services at a lower price than the payment specified in the participation agreement;
B. Requires, or grants the carrier an option to require, the provider to accept a lower payment in the event the provider agrees to provide services to any other carrier at a lower price;
C. Requires, or grants the carrier an option of, termination or renegotiation of the existing participation agreement in the event the provider agrees to provide services to any other carrier at a lower price; or
D. Requires the provider to disclose its reimbursement rates from other carriers.
SUMMARY
This bill prohibits the inclusion of so-called "most favored nation" clauses in the participation agreements between health insurance carriers and health care service providers.