An Act Concerning Insurance Accountability And Transparency.
HB 7116, titled "An Act Concerning Insurance Accountability and Transparency," makes several changes to Connecticut law governing health care contracting and health care cost oversight. First, it expands the list of prohibited contract terms in health care provider agreements to bar not only all-or-nothing clauses, anti-steering clauses, anti-tiering clauses, and gag clauses, but also a new category called revenue neutrality clauses. These provisions are defined broadly and would apply to contracts between health care providers and health carriers, health plan administrators, plan sponsors, and related agents.
The bill also updates and expands definitions used in the state’s health care cost growth and transparency framework, including definitions for drug manufacturer, payer, provider entity, total health care expenditures, and total medical expense. It requires the Commissioner of Health Strategy to provide aggregated data to the Insurance Commissioner beginning March 1, 2026, and annually thereafter, so the state can calculate measures such as total health care expenditures, primary care spending as a share of total medical expense, and the net cost of private health insurance. The Insurance Commissioner is authorized to hire an actuary or other independent expert to audit that data, with the audit report sent to the relevant commissioners and legislative committees.
The bill would amend Section 38a-477i of the general statutes and related health cost reporting provisions in Chapter 368z, strengthening state oversight of insurer-provider contracting and health care spending data. It would make prohibited contract clauses void if entered into or renewed on or after July 1, 2025, while leaving the rest of the contract in force. It also creates a new data-sharing and audit process between the Office of Health Strategy and the Insurance Commissioner, which could affect insurers, self-funded plans, provider systems, drug manufacturers, pharmacy benefit managers, and other entities involved in health care pricing and contracting.
The available voting record suggests generally favorable committee sentiment: the Insurance and Real Estate Committee reported the bill out jointly favorable by an 11-2 vote. No committee transcript was provided, so there is no recorded debate to indicate detailed support or opposition arguments. The vote margin indicates broad support with some dissent, but not strong bipartisan unanimity.
The main points of contention likely center on the bill’s restrictions on contract negotiation terms and its expanded state oversight of health care pricing and data. Providers and health systems may object to limits on all-or-nothing, anti-steering, anti-tiering, and revenue neutrality clauses because those terms can affect network participation, bargaining leverage, and reimbursement arrangements. Insurers, purchasers, and state policymakers are more likely to support the bill because it increases transparency, limits contractual practices viewed as anti-competitive, and gives regulators more tools to audit spending and cost-growth data.