An article here from NWAnews.com is reporting that a “bill filed with the Arkansas Legislature on Tuesday would prohibit managed care networks from practices that “discriminate” against doctors and hospitals, a move the bill’s sponsor says will put an “any willing provider” law into effect.” According to the article:
Senate Bill 43 is intended to open closed insurance networks such as those of Arkansas Blue Cross and Blue Shield, allowing health-care providers who are willing to meet an insurer’s terms to see patients at in-network rate . . .A second bill filed by Faris, SB44, says individuals can sue over violations of SB43 and receive a court order requiring compliance with the law and an award of at least $1,000. . .
SB43 says insurers cannot “discriminate against any provider” who is willing to meet the “terms and conditions for participation.” The bill is the latest in Arkansas’ decade-long fight over “any willing provider,” a term used to describe laws that force insurance companies to extend network membership to any doctor or hospital willing and able to meet the network’s terms.
Here are the events leading up to the introduction of this legislation:
(1) An Arkansas any willing provider law (“AWP law”) called the “Arkansas Patient Protection Act” was passed in 1995, but had been barred from being enforced in Arkansas after a federal district court issued an injunction, holding that the AWP law was subject to preemption under ERISA. The injunction was was affirmed by the 8th Circuit, in the case of of Prudential Insurance Company of America, et al. v.National Park Medical Center, Inc.
(2) The U.S. Supreme Court in the case of Kentucky Association of Health Plans v. Miller decided in April of 2003 that an AWP law in Kentucky was not preempted by ERISA (discussed in previous posts which you can access here.)
(3) After the Miller case was decided, a case was filed in federal district court in Arkansas asking for “a judicial determination” on how the Miller case impacted the old Arkansas AWP law.
(4) The injunction issued in 1998 was lifted on February 12, 2004 by a federal district court in Arkansas, based on the Miller case, but the decision lifting the injunction was appealed to the 8th Circuit. According to the Gazette article, oral arguments in the case–Prudential Ins. Co. v. HMO Partners–were heard in November of last year. You can read about the oral arguments in this article here, or even listen to the oral arguments as well as read the briefs filed in the case here.
According to the article, supporters of the proposed legislation don’t want to wait for the 8th Circuit to rule, and have introduced the legislation, modeling it after the Kentucky AWP law (which was upheld by the Supreme Court), in hopes that it will be enacted, thus bypassing the legal battle that has ensued in the courts.
Read about the legal issues pertaining to AWP laws in this article: “Kentucky’s “Any Willing Provider” Law and ERISA: Implications of the Supreme Court’s Decision for State Health Insurance Regulation” by Patricia A. Butler, JD, DrPH.
An article here from NWAnews.com is reporting that a “bill filed with the Arkansas Legislature on Tuesday would prohibit managed care networks from practices that “discriminate” against doctors and hospitals, a move the bill’s sponsor says will put an “any willing provider” law into effect.” According to the article:
Senate Bill 43 is intended to open closed insurance networks such as those of Arkansas Blue Cross and Blue Shield, allowing health-care providers who are willing to meet an insurer’s terms to see patients at in-network rate . . .A second bill filed by Faris, SB44, says individuals can sue over violations of SB43 and receive a court order requiring compliance with the law and an award of at least $1,000. . .
SB43 says insurers cannot “discriminate against any provider” who is willing to meet the “terms and conditions for participation.” The bill is the latest in Arkansas’ decade-long fight over “any willing provider,” a term used to describe laws that force insurance companies to extend network membership to any doctor or hospital willing and able to meet the network’s terms.
Here are the events leading up to the introduction of this legislation:
(1) An Arkansas any willing provider law (“AWP law”) called the “Arkansas Patient Protection Act” was passed in 1995, but had been barred from being enforced in Arkansas after a federal district court issued an injunction, holding that the AWP law was subject to preemption under ERISA. The injunction was was affirmed by the 8th Circuit, in the case of of Prudential Insurance Company of America, et al. v.National Park Medical Center, Inc.
(2) The U.S. Supreme Court in the case of Kentucky Association of Health Plans v. Miller decided in April of 2003 that an AWP law in Kentucky was not preempted by ERISA (discussed in previous posts which you can access here.)
(3) After the Miller case was decided, a case was filed in federal district court in Arkansas asking for “a judicial determination” on how the Miller case impacted the old Arkansas AWP law.
(4) The injunction issued in 1998 was lifted on February 12, 2004 by a federal district court in Arkansas, based on the Miller case, but the decision lifting the injunction was appealed to the 8th Circuit. According to the Gazette article, oral arguments in the case–Prudential Ins. Co. v. HMO Partners–were heard in November of last year. You can read about the oral arguments in this article here, or even listen to the oral arguments as well as read the briefs filed in the case here.
According to the article, supporters of the proposed legislation don’t want to wait for the 8th Circuit to rule, and have introduced the legislation, modeling it after the Kentucky AWP law (which was upheld by the Supreme Court), in hopes that it will be enacted, thus bypassing the legal battle that has ensued in the courts.
Read about the legal issues pertaining to AWP laws in this article: “Kentucky’s “Any Willing Provider” Law and ERISA: Implications of the Supreme Court’s Decision for State Health Insurance Regulation” by Patricia A. Butler, JD, DrPH.