Officials from Pittsburgh-based Allegheny Health Network are lobbying for "any willing provider" legislation, which would prohibit payers from refusing to contract with any hospitals willing to provide services, according to a Pittsburgh BusinessTimes report.
Advocates of the "any willing provider" legislation have been trying to pass it in Pennsylvania since 1994. AHN administrators support the bill even though it would likely slow its return to fiscal health if Highmark members begin seeing providers from University of Pittsburgh Medical Center, according to the report.
John Dempster, CEO of AHN's Jefferson Regional Medical Center in Jefferson Hills, Pa., said the legislation would empower patients and curb "inappropriate use of market power" to control consumers' choice of healthcare providers, according to the report.
The bill would present a legislative solution to a contract standoff between UPMC and dominant insurer Highmark, parent company of AHN.
UPMC, which has the second-largest health plan in the area, has said it wants its contract with Highmark to expire at the end of 2014, while Highmark does not favor this concept and instead seems to favor a forced resolution.
There is also talk of "premature legislation" — a bill that has yet to be written — that would work the other way around. It would require hospitals operating as part of an integrated delivery network to contract with any willing insurer, according to a Pittsburgh Post-Gazette report.
In other words, Highmark enrollees could go to any UPMC hospital or physician, and their coverage would be honored. But as of Aug. 22, the idea was still in memo form among lawmakers.
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