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Committee reviews S.197 to raise primary‑care payments through Blueprint and set spending targets
Summary
S.197 would require insurers to contribute to higher per‑person primary‑care payments, direct the Agency of Human Services to set spending targets and use the Blueprint to distribute funds; providers warned current Blueprint PMPMs are inadequate.
Lawmakers reviewed S.197 on April 1, a Senate bill that would impose new reporting requirements on insurers, expand the Blueprint for Health’s role in distributing per‑member primary‑care payments, and require the Agency of Human Services to set primary‑care spending targets and a transitional schedule.
Jen KBY of the Office of Legislative Counsel summarized the bill’s main elements: health insurers must submit data to the Agency of Human Services quarterly; Blueprint PMPM payments to participating practices should be based on NCQA medical‑home scores and must be at least equal to Medicaid amounts beginning in 2027; and AHS must publish baseline PMPM spending and proposed target increases with…
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