Concerns standards for non-renewal or termination of certain health care professionals from insurance carrier's provider network.
Impact
The passing of A1452 is expected to have significant implications for state laws governing managed care. It will amend existing regulations by ensuring that health care professionals are not removed from provider networks without a fair opportunity for notice and due process. The Commissioner of Banking and Insurance will be tasked with establishing regulations that define 'good cause' for non-renewal or termination and will do so within 180 days of the bill's enactment.
Summary
Assembly Bill A1452 seeks to establish standardized policies regarding the non-renewal or termination of health care professionals within insurance carriers' provider networks. It aims to protect licensed health care professionals, particularly those who have been part of a carrier's network for five years or longer, from abrupt contract terminations without adequate notice. Specifically, the bill mandates that carriers must provide a written notice of intent not to renew or terminate a contract at least one year prior to the effective date of such actions, along with documentation of the reasons for those decisions.
Contention
While the bill is largely aimed at enhancing protections for health care professionals, it is possible that it may face opposition from insurance carriers concerned about the potential constraints on their flexibility in managing provider networks. Proponents argue that such protections are necessary to maintain a stable health care workforce and to ensure continuity of care for patients. However, skeptics might contend that the regulations could complicate operational decisions for insurance providers and possibly lead to unintended consequences in the health care sector.
Establishes arbitration and notification process for health insurance carriers and provider networks when dispute arises over maintaining providers as in-network.
Requires DOBI to monitor, evaluate, and submit annual report concerning mental health insurance coverage for minors; requires carriers to maintain provider directory.
AN ACT to amend Tennessee Code Annotated, Title 8; Title 33; Title 36; Title 49; Title 52; Title 56; Title 63 and Title 68, relative to professional counselors.
AN ACT to amend Tennessee Code Annotated, Title 8; Title 33; Title 36; Title 49; Title 52; Title 56; Title 63 and Title 68, relative to professional counselors.
Occupations: individual licensing and registration; licensure of professional guardians and conservators; require. Amends sec. 303a of 1980 PA 299 (MCL 339.303a) & adds art. 14A.