Haslam signs bill impacting health plans' fee reimbursements to docs

Haslam signs bill impacting health plans' fee reimbursements to docs

April 10th, 2017 by Andy Sher in Breaking News

NASHVILLE — Without fanfare, Gov. Bill Haslam has signed into law a first-of-its-kind measure that places some restrictions on Tennessee health insurers when making mid-contract changes to doctors and other providers.

The governor signed the bill, sponsored by Sen. Bo Watson, R-Hixson, in the upper chamber last Wednesday, according to the General Assembly's website.

Tennessee Medical Association officials ballyhooed the law, dubbed the Provider Stability Act, in a news release, saying it "breaks new health care ground" and is the first law of its kind nationwide.

The law, sponsored in the House by Rep. Cameron Sexton, R-Crossville, requires health insurance companies to provide 60-day notice to a provider when reimbursement rates change, if such changes are a result of a policy change at the sole discretion of the payer.

It also limits fee schedule changes to once in a 12-month period, requiring a 90-day heads-up on those changes.

"This is a huge win for physicians and all health care providers in Tennessee," said TMA President Keith G. Anderson, a Memphis physician. "TMA listened and has responded to members' growing frustrations by bringing some stability and predictability to the marketplace."

Doctors have been fighting for the change since 2014, charging health plans were jerking providers around. Insurers' contracts with medical practices, hospitals, health systems and other providers routinely include provisions that allow the health plans to lower payments at any time.

Health plans argued such changes benefit millions of ratepayers across the state. But providers, especially doctors, say the practice can result in their dropping the service or dropping of the network, impacting patients who may have to pay higher fees.

The new law, which would go into effect in 2019, came about as a result of a compromise between insurers and doctors.

During one of his presentations last month, Watson, a physical therapist at a local hospital, wryly referred to the bill as "the infamous Provider Stability Act, which I know everyone is tired of hearing about and, amazingly, it is worked out among all parties and everybody is happy with it."

Contact Andy Sher at asher@timesfreepress.com or 615-255-0550.