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Backlash Developing Against Narrow Healthcare Networks

Officials in at least a half- dozen states are taking action against health plans in new insurance markets that restrict the choice of doctors and hospitals to curb medical costs...
December 6, 2013

Officials in at least a half- dozen states are taking action against health plans in new insurance markets that restrict the choice of doctors and hospitals to curb medical costs. Washington State Insurance Commissioner Mike Kreidler, for instance, has prohibited several health plans from the state’s online exchange for what he described as inadequate caregiver networks. Although some of the plans have since widened their networks, the dispute continues with others. Maine Insurance Superintendent Eric Cioppa has prevented Anthem from switching several thousand existing subscribers to a plan that excluded Central Maine Medical Center and partner doctors and hospitals.

The pushback against narrow provider networks recalls the backlash against managed care and health maintenance organizations in the 1990s. Protests from consumers and hospitals eroded those attempts to restrain expenses by narrowing provider networks. In New Hampshire, State Rep. Bill Nelson (R) sponsored an “any-willing-provider” bill that would force insurers to accept more participants in the networks. Pennsylvania, Mississippi and South Dakota are discussing similar measures.

Officials Push Back Against Narrow Networks (MedCity News 11/25/13)

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