Before The Joint Committee On Health Care
Financing
October 3, 2011
The Massachusetts Medical Society strongly opposes this
legislation, which repeals existing law passed in 2010.
Specifically, this bill amends laws which govern the terms
insurers may include in their contracts with providers. It removes
the following language from Chapter 176 O :"
"requires a provider to participate in a new select network or
tiered network plan that the carrier introduces without
granting the provider the right to opt-out of the new plan at
least 60 days before the new plan is submitted to the commissioner
for approval;"
It is wrong for insurers to unilaterally require that physicians
who participate in one plan offered by an insurer must participate
in all current and future plans without their agreeing to do so.
This legislation allows participating providers time to opt out of
a plan with poor patient coverage or poor physician terms 60 days
before the Commissioner reviews the plan. This time line is
important because one element of the Commissioner's review of plans
is the network of providers and whether it will be sufficient to
serve enrollees. If this timeline is eliminated, the Commissioner
may be presented with listings of participating physicians based on
the statistics for an existing insurance product, not the product
under review. The existing statutory language was recently added to
allow both physician autonomy in choosing whether to participate in
a plan and patient protections to ensure approved new insurance
products really have the access to care they project in their
review by the Division of Insurance.
We urge the Committee not to support H 2084.
