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Bill

S 793

An Act to save lives by preventing unscrupulous medical referral restrictions by profit-driven health care networks

194th Legislature (2025-2026) Introduced by Mark Montigny

S 793 prohibits health care networks from restricting patient referrals based on provider profit incentives, ensuring medical decisions prioritize patient care over financial arrangements.

Accompanied a study order, see S2787
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Bill Summary · S 793

Legislative bill overview

S 793 would prohibit health care networks from restricting medical referrals based on profit incentives or financial arrangements between providers. The bill aims to ensure patients can be referred to the most appropriate medical specialists regardless of whether those providers are in the same network or have financial relationships with referring physicians.

Why is this important

Referral restrictions can delay patient care, limit access to specialized treatment, and create conflicts of interest where financial considerations outweigh medical necessity. This bill addresses concerns that patients may not receive optimal care when doctors are financially incentivized to refer within closed networks rather than to the best available specialist.

Potential points of contention

  • Healthcare network economics: Networks argue that referral restrictions help control costs and coordinate care; this bill could increase healthcare expenses if patients are routinely referred outside negotiated networks without cost controls
  • Definition and enforcement: The bill's language around what constitutes "unscrupulous" restrictions and how "profit-driven" motivations would be identified and proven in practice may be vague and difficult to enforce
  • Provider autonomy vs. patient access: Tension between protecting clinical judgment and preventing unnecessary out-of-network referrals that may not be covered by insurance or available to patients with limited financial means

Compiled from official sources — confirm details with the bill’s official record.

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