H.R. 6248: Healthy Competition for Better Care Act
The Healthy Competition for Better Care Act aims to improve healthcare access and affordability by prohibiting certain anticompetitive practices in agreements between health insurance providers and healthcare facilities. Here’s what the bill entails:
Prohibition of Anticompetitive Terms
The bill specifically addresses agreements that:
- Restrict Health Plans: Prevent health plans or insurance issuers from steering participants to specific providers or offering incentives to encourage the use of different healthcare providers.
- Impose Additional Agreements: Require health plans to enter agreements with affiliates of the healthcare provider.
- Regulate Payment Terms: Force health plans to agree to payment rates or conditions for non-affiliated entities within the network.
- Limit Competition: Restrict other health plans from paying lower rates for items or services than those agreed upon by the planning organization.
Exceptions to the Rules
There are exceptions for:
- Health maintenance organizations (HMOs) that primarily operate through exclusive contracts with multi-specialty physician groups.
- Value-based network arrangements, such as accountable care organizations or integrated health systems.
Definitions and Clarifications
The bill provides definitions for key terms, especially “covered entity,” which includes healthcare providers and networks that supply access to a specific set of services or providers.
Regulatory Measures
The Secretary of Health and Human Services, along with other relevant departments, is tasked to establish regulations to enforce these amendments within one year of the bill becoming law. The amendments will apply to contracts that are entered into, modified, or renewed 18 months after the bill’s enactment.
Impact on Healthcare Plans
The bill is designed to enhance the flexibility of health plans in designing their networks, improving competition by allowing more options for participants, and potentially leading to lower healthcare costs through broader access to alternative providers.
Relevant Companies
- UNH - UnitedHealth Group: This health insurance company may be affected by the changes in contract agreements with healthcare providers.
- CNC - Centene Corporation: As a large health insurer, Centene could see operational impacts regarding provider network agreements and incentives.
This is an AI-generated summary of the bill text. There may be mistakes.
Sponsors
4 bill sponsors
Actions
2 actions
| Date | Action |
|---|---|
| Nov. 21, 2025 | Introduced in House |
| Nov. 21, 2025 | Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. |
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