In formal comments submitted to the U.S. Departments of Health and Human Services (HHS), Treasury and Labor, the American Society of Anesthesiologists (ASA) has urged the Departments to accurately interpret and implement the so-called provider “non-discrimination” provisions included in the Affordable Care Act. ASA was joined on the letter by the American Academy of Ophthalmology (AAO), the American Association of Orthopaedic Surgeons (AAOS), and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS).
In recent months, the non-physician community has undertaken a campaign to push the Departments to inappropriately expand upon their interpretation of the non-discrimination provision. The groups and their Congressional allies have expressed concern that the Departments’ current interpretation would allow health plans and insurance issuers to exclude from participation whole categories of providers operating under a State license or certification. The groups and their allies have also argued that the provision was intended to preclude discrimination in payment rates based on broad market considerations rather than performance and quality measures.
In an effort to advance patient safety and quality, the ASA’s patient-centered comment letter submitted to HHS supports the Department’s current interpretation of the law and states its belief that “it is the most appropriate approach for ensuring that health plans and insurance issuers have the flexibility and discretion to develop provider networks that will protect patients and maintain quality of care within the boundaries of state scope of practice laws.”
The comment letter to HHS from ASA also states:
“We support the Departments’ efforts to meet the non-discrimination purposes of § 2706(a) while also seeking to give health plans and insurance issuers sufficient flexibility in selecting their provider panels to ensure their beneficiaries receive high quality care. Our support for the Departments’ position is based on the plain language of § 2706(a) and the need to ensure health plans and insurance issuers offer the most qualified providers to their participants. Additionally, we support the Departments’ position, based on consistency with previous CMS interpretations of provider non-discrimination laws and practical need, to allow insurers to consider market factors to attract and retain a range of providers.”
Click here to read the full letter submitted to HHS on the provider non-discrimination provisions.