I 
119TH CONGRESS 
1ST SESSION H. R. 6248 
To ban anticompetitive terms in facility and insurance contracts that limit 
access to higher quality, lower cost care. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 21, 2025 
Mr. ARRINGTON (for himself, Mr. DAVIS of North Carolina, and Mr. ALLEN) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committees on Education and 
Workforce, and Ways and Means, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To ban anticompetitive terms in facility and insurance 
contracts that limit access to higher quality, lower cost care. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Healthy Competition 
for Better Care Act’’. 
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SEC. 2. BANNING ANTICOMPETITIVE TERMS IN FACILITY 
AND INSURANCE CONTRACTS THAT LIMIT AC-
CESS TO HIGHER QUALITY, LOWER COST 
CARE. 
(a) IN GENERAL.— 
(1) PHSA.— 
(A) IN GENERAL.—Section 2799A–9 of the 
Public Health Service Act (42 U.S.C. 300gg– 
119) is amended by adding at the end the fol-
lowing: 
‘‘(b) PROTECTING HEALTH PLANS NETWORK DE-
SIGN FLEXIBILITY.— 
‘‘(1) IN GENERAL.—A group health plan or a 
health insurance issuer offering group or individual 
health insurance coverage may not enter into an 
agreement with a covered entity (as defined in para-
graph (3)) if such agreement, directly or indirectly— 
‘‘(A) restricts (including by operation of 
any agreement in effect between such covered 
entity and another covered entity) the group 
health plan (whether self-insured or fully in-
sured) or health insurance issuer from— 
‘‘(i) directing or steering participants 
or beneficiaries to other health care pro-
viders who are not subject to such agree-
ment; or 
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‘‘(ii) offering incentives to encourage 
participants or beneficiaries to utilize spe-
cific health care providers; 
‘‘(B) requires the group health plan or 
health insurance issuer to enter into any addi-
tional agreement with an affiliate of the covered 
entity; 
‘‘(C) requires the group health plan or 
health insurance issuer to agree to payment 
rates or other terms for any affiliate of the cov-
ered entity not party to the agreement; or 
‘‘(D) restricts other group health plans or 
health insurance issuers not party to the agree-
ment from paying a lower rate for items or 
services than the plan or issuer involved in the 
agreement pays for such items or services. 
‘‘(2) EXCEPTIONS
FOR
CERTAIN
PROVIDER 
GROUP
AND
VALUE-BASED
NETWORK
DESIGNS.— 
Paragraph (1)(A) shall not apply to a group health 
plan or health insurance issuer offering group or in-
dividual health insurance coverage with respect to— 
‘‘(A) a health maintenance organization 
(as defined in section 2791(b)(3)), if such 
health maintenance organization operates pri-
marily through exclusive contracts with multi- 
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specialty physician groups, nor to any arrange-
ment between such a health maintenance orga-
nization and its affiliates; or 
‘‘(B) a value-based network arrangement, 
such as an exclusive provider network, account-
able care organization, center of excellence, a 
provider sponsored health insurance issuer that 
operates primarily through aligned multi-spe-
cialty physician group practices or integrated 
health systems, or such other similar network 
arrangements as determined by the Secretary 
through guidance or rulemaking. 
‘‘(3) COVERED
ENTITY
DEFINED.—For pur-
poses of this subsection, the term ‘covered entity’ 
means a health care provider, network or association 
of providers, third-party administrator, or other 
service provider offering access to a network of pro-
viders. 
‘‘(4) RULE OF CONSTRUCTION.—Except as pro-
vided in paragraph (1), nothing in this subsection 
shall be construed to limit network design or cost or 
quality initiatives by a group health plan or health 
insurance issuer, including accountable care organi-
zations, exclusive provider organizations, networks 
that tier providers by cost or quality or steer enroll-
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ees to centers of excellence, or other pay-for-per-
formance programs.’’. 
(B) REGULATIONS.—Not later than 1 year 
after the date of the enactment of this Act, the 
Secretary of Health and Human Services, in 
consultation with the Secretary of Labor and 
the Secretary of the Treasury, shall promulgate 
regulations to carry out the amendments made 
by this paragraph. 
(2) EMPLOYEE RETIREMENT INCOME SECURITY 
ACT OF 1974.— 
(A) IN GENERAL.—Section 724 of the Em-
ployee Retirement Income Security Act of 1974 
(29 U.S.C. 1185m) is amended— 
(i) in the header, by striking ‘‘BY RE-
MOVING’’ and all that follows through 
‘‘INFORMATION’’ and inserting ‘‘; PRO-
HIBITION
ON
ANTICOMPETITIVE 
AGREEMENTS’’; 
(ii) in subsection (a)(4), in the first 
sentence, by striking ‘‘section’’ and insert-
ing ‘‘subsection’’; and 
(iii) by adding at the end the fol-
lowing: 
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‘‘(b) PROTECTING HEALTH PLANS NETWORK DE-
SIGN FLEXIBILITY.— 
‘‘(1) IN GENERAL.—A group health plan or a 
health insurance issuer offering group health insur-
ance coverage may not enter into an agreement with 
a covered entity (as defined in paragraph (3)) if 
such agreement, directly or indirectly— 
‘‘(A) restricts (including by operation of 
any agreement in effect between such covered 
entity and another covered entity) the group 
health plan (whether self-insured or fully in-
sured) or health insurance issuer from— 
‘‘(i) directing or steering participants 
or beneficiaries to other health care pro-
viders who are not subject to such agree-
ment; or 
‘‘(ii) offering incentives to encourage 
participants or beneficiaries to utilize spe-
cific health care providers; 
‘‘(B) requires the group health plan or 
health insurance issuer to enter into any addi-
tional agreement with an affiliate of the covered 
entity; 
‘‘(C) requires the group health plan or 
health insurance issuer to agree to payment 
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rates or other terms for any affiliate of the cov-
ered entity not party to the agreement; or 
‘‘(D) restricts other group health plans or 
health insurance issuers not party to the agree-
ment from paying a lower rate for items or 
services than the plan or issuer involved in the 
agreement pays for such items or services. 
‘‘(2) EXCEPTIONS
FOR
CERTAIN
PROVIDER 
GROUP
AND
VALUE-BASED
NETWORK
DESIGNS.— 
Paragraph (1)(A) shall not apply to a group health 
plan or health insurance issuer offering group health 
insurance coverage with respect to— 
‘‘(A) a health maintenance organization 
(as defined in section 733(b)(3)), if such health 
maintenance organization operates primarily 
through exclusive contracts with multi-specialty 
physician groups, nor to any arrangement be-
tween such a health maintenance organization 
and its affiliates; or 
‘‘(B) a value-based network arrangement, 
such as an exclusive provider network, account-
able care organization, center of excellence, a 
provider sponsored health insurance issuer that 
operates primarily through aligned multi-spe-
cialty physician group practices or integrated 
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health systems, or such other similar network 
arrangements as determined by the Secretary 
through guidance or rulemaking. 
‘‘(3) COVERED
ENTITY
DEFINED.—For pur-
poses of this subsection, the term ‘covered entity’ 
means a health care provider, network or association 
of providers, third-party administrator, or other 
service provider offering access to a network of pro-
viders. 
‘‘(4) RULE OF CONSTRUCTION.—Except as pro-
vided in paragraph (1), nothing in this subsection 
shall be construed to limit network design or cost or 
quality initiatives by a group health plan or health 
insurance issuer, including accountable care organi-
zations, exclusive provider organizations, networks 
that tier providers by cost or quality or steer enroll-
ees to centers of excellence, or other pay-for-per-
formance programs.’’. 
(B) CLERICAL AMENDMENT.—The table of 
contents in section 1 of such Act is amended, 
in the entry relating to section 724, by amend-
ing such entry to read as follows: 
‘‘Sec. 724. Increasing transparency; prohibition on anticompetitive agree-
ments.’’. 
(C) REGULATIONS.—Not later than 1 year 
after the date of the enactment of this Act, the 
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Secretary of Labor, in consultation with the 
Secretary of Health and Human Services and 
the Secretary of the Treasury, shall promulgate 
regulations to carry out the amendments made 
by this paragraph. 
(3) IRC.— 
(A) IN GENERAL.—Section 9824 of the In-
ternal Revenue Code of 1986 is amended— 
(i) in the header, by striking ‘‘BY RE-
MOVING’’ and all that follows through 
‘‘INFORMATION’’ and inserting ‘‘; PRO-
HIBITION
ON
ANTICOMPETITIVE 
AGREEMENTS’’; 
(ii) in subsection (a)(4), in the first 
sentence, by striking ‘‘section’’ and insert-
ing ‘‘subsection’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(b) PROTECTING HEALTH PLANS NETWORK DE-
SIGN FLEXIBILITY.— 
‘‘(1) IN GENERAL.—A group health plan may 
not enter into an agreement with a covered entity 
(as defined in paragraph (3)) if such agreement, di-
rectly or indirectly— 
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‘‘(A) restricts (including by operation of 
any agreement in effect between such covered 
entity and another covered entity) the group 
health plan (whether self-insured or fully in-
sured) from— 
‘‘(i) directing or steering participants 
or beneficiaries to other health care pro-
viders who are not subject to such agree-
ment; or 
‘‘(ii) offering incentives to encourage 
participants or beneficiaries to utilize spe-
cific health care providers; 
‘‘(B) requires the group health plan to 
enter into any additional agreement with an af-
filiate of the covered entity; 
‘‘(C) requires the group health plan to 
agree to payment rates or other terms for any 
affiliate of the covered entity not party to the 
agreement; or 
‘‘(D) restricts other group health plans not 
party to the agreement from paying a lower 
rate for items or services than the plan involved 
in the agreement pays for such items or serv-
ices. 
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‘‘(2) EXCEPTIONS
FOR
CERTAIN
PROVIDER 
GROUP
AND
VALUE-BASED
NETWORK
DESIGNS.— 
Paragraph (1)(A) shall not apply to a group health 
plan with respect to— 
‘‘(A) a health maintenance organization 
(as defined in section 9832(b)(3)), if such 
health maintenance organization operates pri-
marily through exclusive contracts with multi- 
specialty physician groups, nor to any arrange-
ment between such a health maintenance orga-
nization and its affiliates; or 
‘‘(B) a value-based network arrangement, 
such as an exclusive provider network, account-
able care organization, center of excellence, a 
provider sponsored health insurance issuer that 
operates primarily through aligned multi-spe-
cialty physician group practices or integrated 
health systems, or such other similar network 
arrangements as determined by the Secretary 
through guidance or rulemaking. 
‘‘(3) COVERED
ENTITY
DEFINED.—For pur-
poses of this subsection, the term ‘covered entity’ 
means a health care provider, network or association 
of providers, third-party administrator, or other 
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service provider offering access to a network of pro-
viders. 
‘‘(4) RULE OF CONSTRUCTION.—Except as pro-
vided in paragraph (1), nothing in this subsection 
shall be construed to limit network design or cost or 
quality initiatives by a group health plan, including 
accountable care organizations, exclusive provider or-
ganizations, networks that tier providers by cost or 
quality or steer enrollees to centers of excellence, or 
other pay-for-performance programs.’’. 
(B) CLERICAL AMENDMENT.—The table of 
contents in section 1 of such Act is amended, 
in the entry relating to section 9824, by amend-
ing such entry to read as follows: 
‘‘Sec. 9824. Increasing transparency; prohibition on anticompetitive agree-
ments.’’. 
(C) REGULATIONS.—Not later than 1 year 
after the date of the enactment of this Act, the 
Secretary of the Treasury, in consultation with 
the Secretary of Health and Human Services 
and the Secretary of Labor, shall promulgate 
regulations to carry out the amendments made 
by this paragraph. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply with respect to any contract en-
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tered into, amended, or renewed on or after the date that 
is 18 months after the date of enactment of this Act. 
Æ 
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