Health care providers certain health care provider reimbursement arrangements disclosure to enrollees and health care providers requirement provision, Ombudsperson for public managed health care programs duties modifications, and health carrier liability when a health care provider is limited in providing services by the health carrier

SF 1107 requires health plans, insurers, and providers to clearly disclose how their reimbursement methods might limit care to enrollees. Specifically, they must explain payment structures that reward volume, capitation (fixed cost per patient), or provider tiering, including how these could restrict services like referrals or specialist access. This disclosure must be provided during enrollment, annually, and upon request in English, Spanish, Vietnamese, and Hmong. The bill also modifies ombudsman duties for public health programs and adds liability for health carriers that limit provider services without justification. It directly affects enrollees, providers, and health plans by increasing transparency around financial incentives that could impact care.