Provider Stability Act Unanimously Passed

The Medical Society and TMA have been working together, on the behalf of our physician members, to address the frustrations of healthcare insurers lowering reimbursement rates for services without any notice or reason. Over the last three years, CHCMS and TMA have worked with Sen. Bo Watson and Rep. Sexton to pass legislation to add much-needed financial predictability for medical practices and hospitals. We are happy to announce the Provider Stability Act unanimously was passed by the Tennessee General Assembly and signed into law by Governor Bill Haslam on Wednesday.

Below is the news release sent to Tennessee media by the TMA announcing the legislative win for physicians and healthcare providers. The Chattanooga Times Free Press posted an article on their website today.

Thanks to our member physicians, practice managers, and administrators for doing their part in contacting our local legislative delegation about the issue and traveling to Nashville for Doctors Day on the Hill to share our concerns. It is with your input and support that we were able to pass this meaningful legislation.

As always, thank you for being a member of the Medical Society and TMA and supporting organized medicine in Tennessee. Without you, none of this is possible. Please encourage colleagues currently not members to join us in making Tennessee a better place for all physicians to practice. Together we are stronger!

FOR IMMEDIATE RELEASE     

April 10, 2017

TENNESSEE MEDICAL ASSOCIATION BREAKS NEW HEALTHCARE GROUND WITH LEGISLATIVE WIN
Provider Stability Act First of its Kind in the U.S                                                                         

NASHVILLE – Tennessee doctors are praising a new state law that adds much-needed financial predictability in contracts between health plans and healthcare providers. The Provider Stability Act passed unanimously in both chambers of the Tennessee General Assembly and was signed by Governor Haslam on April 5.

Senate Bill 437/House Bill 498 was sponsored by Sen. Bo Watson (R-Hixson) and Rep. Cameron Sexton (R-Crossville). It requires health insurance companies to give a 60-day notice to a healthcare provider when reimbursement rates change, if such changes are a result of a policy change at the sole discretion of the payer. It also limits fee schedule changes to once in a 12-month period, and requires a 90-day notice of those changes.

The Tennessee Medical Association, which represents more than 9,000 Tennessee physicians, has pushed the measure since 2014. 

No other state currently has these types of provisions in place.

“This is a huge win for physicians and all healthcare providers in Tennessee,” said TMA President Keith G. Anderson, MD of Memphis. “TMA listened and has responded to members’ growing frustrations by bringing some stability and predictability to the marketplace.”

Medical practices, hospitals, health systems and other healthcare providers enter into contracts with health plans to spell out exactly what will the insurer will pay for healthcare services provided to patients covered by that health insurance plan. The contracts are routinely written to allow insurers to lower payment at any time, for any reason.

“The intent of the Provider Stability Act from the very beginning was to have health plans honor network contract provisions and stop the one-sided, ‘take-it-or-leave-it’ rate cuts that threaten physicians’ financial stability, and disrupt patient care,” said Dr. Anderson. "When doctors cannot afford to incur an unexpected change in reimbursement from a health plan they may be forced to stop providing a procedure or drop out of the network altogether. Patients suffer by having to pay higher “out-of-network” fees for the same service if they want to continue seeing their doctor, or find another doctor who is in their insurer’s network. The new law will reduce these scenarios and help protect the important patient-physician relationship.

TMA said passage of the Provider Stability Act was made possible by member physicians, medical practice administrators and others who made calls, wrote letters and emails and visited Capitol Hill to speak directly with legislators about the issue. Several other organizations also supported the effort, including the Tennessee Hospital Association, Tennessee Medical Group Management Association, Tennessee Radiological Society, Tennessee Chiropractic Association, Tennessee Orthopaedic Society, Tennessee teaching hospitals, practice administrators and nurses.  

Learn more about TMA’s legislative efforts at tnmed.org/legislative.

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About the Tennessee Medical Association
TMA is the state’s largest professional association for physicians, serving more than 9,000 members. We improve the health of Tennessee by bringing all physicians together in efforts to continually improve effectiveness of physician care and ensure proper policy to serve the best interests of patients and the profession. tnmed.org