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House Co-Sponsorship Memoranda
House of Representatives
Session of 2013 - 2014
Regular Session
MEMORANDUM
| Posted: | December 18, 2012 10:24 AM |
|---|---|
| From: | Representative Anthony M. DeLuca |
| To: | All House members |
| Subject: | “Any Willing Provider” Legislation, HB1965 of 2011 |
| In the near future, I will be re-introducing legislation (HB1965 of 2011) to ensure that private practitioners and facilities remain “in network” if they are qualified and willing to accept the terms of the contract. Pennsylvania currently does not have “Any Willing Provider (AWP) legislation despite multiple attempts. Under an AWP law, any health insurer may not refuse to accept as a participating provider any provider in its geographic area who is willing to meet its conditions of participation. The definition of "insurer" includes insurance companies; health maintenance organizations, or HMOs; self-insurers who are not exempt from state regulation by ERISA; dental service corporations; and other entities. When selection is limited on the insurance side but not on the provider’s end, quality health care may not always be obtained at a reasonable price. Through this legislation, we hope to ensure that employers and others who pay for health insurance are receiving the best value for their dollar. The entity that sets the premium rates charged to subscribers should not be permitted to also determine the rates received as a provider of hospitals and other services. It is necessary that we pass an “Any Willing Provider” law to safeguard insurer-owned providers. |
Introduced as HB222