Insurers on reference pricing: Go easy

Insurers are asking federal regulators to go easy on them when it comes to reference pricing--a provision of the Affordable Care Act that allows insurers to cap prices on physician services. The U.S. Department of Health and Human Services, along with the Internal Revenue Service and the Employee Benefits Security Administration called for comments on reference pricing this summer, reports LifeHealthPro. Oftentimes, an insurer will use reference pricing in lieu of a traditional managed care network. Then, the insurer pays the reference price for the medical cost while the patient covers the rest of the bill. Anthony Mader, vice president at WellPoint, commented that reference pricing should be used for common procedures and not for emergency services. Article