State Oversight of Health Insurer-Provider Contracts
There are important health insurance market and delivery system issues that are developing across the commonwealth. In response, the state legislature is considering changes in state oversight of insurer and hospital contracts.
HAP believes there is a compelling public policy interest for the state to ensure that there is a competitive insurance market to enable broad access to coverage.
However, HAP opposes legislation that would result in a regulatory framework that either:
- Prevents health care providers from being able to effectively structure contractual relationships with health plans
- Unduly interferes with insurance market competition
Payor Practices Reform
HAP supports House Bill 1194,
sponsored by Representative Steven Mentzer (R-Lancaster), to protect against
inappropriate use of prior authorization practices. That action leads
to delays in patients receiving medically necessary care and creates
significant administrative burdens for providers, which
further detracts from patient care.
inappropriate use of prior authorization has been shown to increase health care
costs for businesses, consumers, and government payors, and also has a
significant impact on quality of care. A
of health care practitioners shows that 92 percent report prior authorization
having a negative impact on patient clinical outcomes.