Has a Health Plan Kicked You Out of its Network?
TMA Wants to Know About It as Well as Your IDR Experience
August 12, 2022
Nashville, TN — Several TMA members recently reported that health insurance plans issued network termination letters to several practices and physicians. It appears that hospital-based physicians are the primary targets of these actions. Some members received follow-up letters from the health plans offering to reinstate them into the networks only if they agree to deep cuts in reimbursement for their services.
If this is happening to TMA members, TMA would like a copy of the termination letter. TMA plans to share the letters with the Centers for Medicare and Medicaid Services (CMS). The Secretary of Health and Human Services has authority under the No Surprises Act to study the effect of the Act on access to medical services. Additionally, the Government Accountability Office (GAO) is tasked with submitting a report on the effects of the Act with respect to provider networks, fee schedules, contracted rates, and amounts of health care services. Let us know as well the impact in terms of reduction in reimbursement the health plans’ actions have on your practice.
TMA is also interested in submitting member feedback from physicians or practices which have participated in the independent dispute resolution process pursuant to the No Surprises Act. Please share your experiences with us.
Please submit letters and feedback to Tabitha Lara, TMA’s Director of Insurance Affairs, by email firstname.lastname@example.org, or by mail to Tennessee Medical Association, Attention: Tabitha Lara, 701 Bradford Avenue, Nashville, TN 37204, as soon as possible. Any information submitted will be first be redacted so that no practice or physician identifying information will be shared with any agency of the federal government.