Here we go again! Another government mandate to coddle consumers who are too dumb and lazy to take care of themselves. It seems the general public is so helpless and lost in our health care delivery system that they cant pick up a telephone and call the doctor they want to see to determine if they are still in-network or not.
Maybe insurers need to consider getting rid of networks and just pay fair and reasonable rates. That is what more and more self-funded groups in Texas are doing.
A bill requiring insurers to notify the insurance commissioner and affected members before they terminate a provider contract has reached the desk of the California governor.
The bill (AB 2152), which was sponsored by Insurance Commissioner Dave Jones and passed during the final week of the 2011-2012 California legislative session, would force insurers to inform PPO members 10 days in advance of a contract termination with their provider or hospital, therefore making a visit to that provider out of network.
“At least [consumers] will know ahead of time, if they really, really want to go to that doctor or hospital, what they’re going to be charged for,” Jones told the North County Times.
Plus, insurers would have to tell the California Department of Insurance at least 30 days in advance of a contract termination. The department will then verify that the insurer still has an adequate provider network, reported LifeHealthPro.
The bill was partly spurred by recent high-profile contract terminations between payers and providers. Despite requests from the insurance commissioner’s office, Blue Shield of California refused to notify its members that it was terminating its contract with UCLA Medical Center and refused to cover the cost difference for affected members to see the newly terminated providers out of network. And last month, Aetna ended several contracts without informing the department, FierceHealthPayer previously reported.
Read more: Bill would make insurers notify members of provider contracts ending – FierceHealthPayer http://www.fiercehealthpayer.com/story/bill-would-make-insurers-notify-members-provider-contracts-ending/2012-09-18#ixzz2AJpcICcN
