Gov signs compromise in doctors-vs-insurance companies lobbying fight

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, reports the Times-Free Press.

The governor signed the bill, sponsored by Sen. Bo Watson, R-Hixson, (SB437) 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. (Note: The TMA press release is HERE.)

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.

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