CT restricts use of 'silent PPOs'

Connecticut's legislature has joined a growing trend by adopting measures setting limits on insurers' practices of renting access to physician networks, taking a fee from the renting party while turning over none of the benefits to physicians. Typically, the primary insurer doing the renting offers the lowest rates that physician agreed to with any insurer.

The network rentals, known as "silent PPOs," have stirred up vigorous opposition among physician groups, who argue that such arrangements unfairly extend discounts on their services to companies who never approach or negotiate with them directly. Thanks in part to physician activism, more than a dozen states currently have laws on the books restricting or prohibiting the use of these arrangements.

The measure requires insurers to let contracting doctors know if they plan to sell or rent access to network discounts. It also requires insurers to maintain a list of all secondary parties who sign network rental agreements. In addition, the bill requires secondary silent PPO renters to pay on the same terms as the primary contract, and cancels the second party's contract if the first is canceled. What's more, it requires that remittance notices state clearly which entity is going to pay a bill.

To learn more about this law:
- read this AMNews piece

Related Article:
Ohio law makes health plans disclose contract terms

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