A new Ohio law has been enacted that requires health plans to provide significantly more information in their contracts with physicians, as well as change their contracting practices. Among other things, the new law requires such contracts to offer clearer statements of what the insurer will pay for services, provide a summary section outlining key parts of the agreement and provide notice of significant changes to contracts. The measure also imposes a two-year moratorium on "most-favored-nation" clauses, which require physicians to give an insurer the lowest price for its members. Not only that, it limits "network rentals" or silent PPOs, in which health plans get access to other insurers' networks, then pay their doctors the lowest rate they find. Meanwhile, the new law calls for the development of a web-based eligibility verification system that lets physicians know if care is covered, and what portion of charges patients will pay.
To learn more about the new law:
- read this AMNews article
Related Articles:
OH may make health plans disclose fees. Report
New York AG expands health plan investigation. Report
CA accuses UnitedHealth of 'unfair' practices. Article