Supreme Court "Provider Case"
Charles Barocas
Description
Collection
Title:
Supreme Court "Provider Case"
Creator:
Charles Barocas
Date:
1/15/2003
Text:
High Court Hears any willing provider case
Yesterday, Kentucky told the Supreme Court that it should be allowed to
guarantee patients a broader choice of doctors (and other providers)through
a state law regualating managed care companies.
Under its any willing provider law Kentuckey, like 24 other states,
requires health maintenance organizations to open their networks to any
provider willing to abide by the rules (read $charges) of the network.
The Kentcky Association of Health Plans (boo!) argued that the state law
usurped the power of the feds to regulate employee benefit plans.
If the the Supreme Court rules for the State of Kentucky over the HMO's,
every state will be lobbied by Professional Organizations to invoke the any
willing provider rule. Professional relationships will matter again. Not
just what insurance the patient has.
But I also see every Orthopedic Surgeon will starting their own rehab (if
they don't have one yet) as well as in-house orthotics. The OT (small
practices) or CO (large practices) could operate it for them just as the PT
runs the rehab. Why give away a profit center. And the Doc can do it
cheaper than a stand alone Orthotic shop. This ruling could be another
nail in the coffin for O&P shops OR it could be the start of a wave of new
O&P shops to compete with the big boys who gobbled up all the contracts.
Time will tell.
Charles Barocas, CO
Charles Barocas, CO
_________________________________________________________________
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<URL Redacted>
Yesterday, Kentucky told the Supreme Court that it should be allowed to
guarantee patients a broader choice of doctors (and other providers)through
a state law regualating managed care companies.
Under its any willing provider law Kentuckey, like 24 other states,
requires health maintenance organizations to open their networks to any
provider willing to abide by the rules (read $charges) of the network.
The Kentcky Association of Health Plans (boo!) argued that the state law
usurped the power of the feds to regulate employee benefit plans.
If the the Supreme Court rules for the State of Kentucky over the HMO's,
every state will be lobbied by Professional Organizations to invoke the any
willing provider rule. Professional relationships will matter again. Not
just what insurance the patient has.
But I also see every Orthopedic Surgeon will starting their own rehab (if
they don't have one yet) as well as in-house orthotics. The OT (small
practices) or CO (large practices) could operate it for them just as the PT
runs the rehab. Why give away a profit center. And the Doc can do it
cheaper than a stand alone Orthotic shop. This ruling could be another
nail in the coffin for O&P shops OR it could be the start of a wave of new
O&P shops to compete with the big boys who gobbled up all the contracts.
Time will tell.
Charles Barocas, CO
Charles Barocas, CO
_________________________________________________________________
Add photos to your e-mail with MSN 8. Get 2 months FREE*.
<URL Redacted>
Citation
Charles Barocas, “Supreme Court "Provider Case",” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/220512.
