Re: Linkia and Managed Care
Kim L. Ruhl CPO
Description
Collection
Title:
Re: Linkia and Managed Care
Creator:
Kim L. Ruhl CPO
Date:
7/25/2006
Text:
List Members,
M. Britt Spears CPO wrote:
Jim/List,
I really think that the solution to these problems with closed door insurance companies is the Any Willing Provider Law. Since it's taken effect in Arkansas, insurance companies have been forced to deal with us little guys. They may not send the check directly to you, the patient instead, but you will get paid. I know that it's taken effect in Kentucky where it originated, I'm not sure from our KY people how it's worked there, I'd like to hear from some of them.
My response:
Any Willing Provider Laws, are a futile attempt to level the playing field by stopping anti-competitive practices.
Here's why:
Any Willing Provider Laws are simply not designed or capable of adequately addressing the full scope of the problem as they leave criminals a gaping loophole. If a given insurance company's contract prices are discounted below the point of profitability, the Willing provider must choose to engage in criminal fraud to turn a profit or simply refuse the case altogether. Neither option resolves the original problem for the honest law abiding provider. Therefore unless predatory pricing and kickbacks are also simultaneously addressed, Any Willing Provider Laws can only succeed in perpetuating injustice.
Just some additional food for thought in this discussion.
Sincerely,
Kim L. Ruhl CPO
M. Britt Spears CPO wrote:
Jim/List,
I really think that the solution to these problems with closed door insurance companies is the Any Willing Provider Law. Since it's taken effect in Arkansas, insurance companies have been forced to deal with us little guys. They may not send the check directly to you, the patient instead, but you will get paid. I know that it's taken effect in Kentucky where it originated, I'm not sure from our KY people how it's worked there, I'd like to hear from some of them.
My response:
Any Willing Provider Laws, are a futile attempt to level the playing field by stopping anti-competitive practices.
Here's why:
Any Willing Provider Laws are simply not designed or capable of adequately addressing the full scope of the problem as they leave criminals a gaping loophole. If a given insurance company's contract prices are discounted below the point of profitability, the Willing provider must choose to engage in criminal fraud to turn a profit or simply refuse the case altogether. Neither option resolves the original problem for the honest law abiding provider. Therefore unless predatory pricing and kickbacks are also simultaneously addressed, Any Willing Provider Laws can only succeed in perpetuating injustice.
Just some additional food for thought in this discussion.
Sincerely,
Kim L. Ruhl CPO
Citation
Kim L. Ruhl CPO, “Re: Linkia and Managed Care,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/226911.
