Digital Doc: New law quietly passed in Tennessee seen as big win for physician reimbursement: 5 things to know
Republican Tennessee Gov. Bill Haslam signed a bill requiring health insurers to notify physicians about mid-contract changes to reimbursements and fee schedules in advance.
Here are five things to know about the bill.
1. Gov. Haslam signed the legislation into law April 5. House Bill 498/Senate Bill 437, dubbed the "Provider Stability Act," will take effect Jan. 1, 2019.
2. The bill requires insurers to give providers at least a 60-day notice before changes are made to reimbursement rates in the sole discretion of the payer.
3. In addition, the measure prohibits payers from changing a provider's fee schedule more than once within a 12-month period. The bill also extends when insurers must notify providers about any fee schedule changes from 30 days to at least 90 days before the effective date.
4. While insurers argue the ability to change reimbursements and fee schedules can benefit policyholders, providers said the law will add financial predictability in payer-provider contracts.
5. The Tennessee Medical Association, representing more than 9,000 physicians, has advocated for the bill — which it calls the "first of its kind" in the U.S. — since 2014. TMA President Keith Anderson, MD, said the measure "is a huge win for physicians and all healthcare providers in Tennessee" and it brings "some stability and predictability to the marketplace."
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