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Recent developments in 'any willing provider' legislation.
G A Niederman1, J D Christiansen, K Phillips
1Fagre & Benson, Denver, CO 80202.
Medical Group Management Journal
|August 6, 1994
Summary
Recent state legislation may prevent health care networks from selecting qualified providers. This analysis reviews the background, trends, and impacts of "any willing provider" laws on provider choice and network flexibility.
Area of Science:
- Health Law
- Healthcare Policy
- Managed Care
Background:
- State-level legislation is increasingly impacting health care network provider selection.
- The principle of 'any willing provider' (AWP) laws challenges traditional network management.
- AWP laws affect the autonomy of health care networks in contracting with providers.
Purpose of the Study:
- To provide an overview of the background and evolution of any willing provider laws.
- To analyze current trends related to the implementation and scope of AWP legislation.
- To assess the potential impacts of AWP laws on health care networks and provider choice.
Main Methods:
- Review of state legislation concerning provider network selection.
- Analysis of legal trends and court decisions impacting AWP laws.
- Discussion of the practical implications for health care organizations.
Main Results:
- AWP laws mandate that networks accept any provider willing to abide by contract terms.
- Legislation varies by state, creating a complex regulatory landscape.
- Potential impacts include reduced network control and increased administrative burden.
Conclusions:
- AWP laws significantly alter the provider contracting process for health care networks.
- Understanding these laws is crucial for navigating current healthcare market dynamics.
- Networks must adapt to legislative changes affecting provider inclusion.