A coalition of provider and managed-care groups is leading a very visible campaign against efforts to force health plans to admit all qualifying providers into their networks.
The groups contend there is a move by some physician groups to add such provisions to national health reform legislation in Congress.
While most of the action on such provisions, called "any-willing-provider" laws, has been at the state level, the American Medical Association has been working to drum up support among members of Congress for a scaled-down version to be included in national healthcare reform. Any-willing-provider laws require plans to open their doors to any physician willing to accept the plans' payment and quality-of-care rules.
Managed-care groups oppose such laws, saying they diminish the plans' ability to control costs and coordinate care.
Last week, a coalition that included the American Hospital Association, the American Group Practice Association, the Federation of American Health Systems and more than a dozen other provider, employer and managed-care groups, sent a letter to all members of Congress that said any-willing-provider laws would "paralyze (providers') ability to assure quality and manage costs."
A separate letter was sent by a group of more than 60 employers that also is opposing the provision.
While the AMA insists it is not actively pushing an any-willing-provider provision, the move has been gaining support in Congress recently. In a letter sent to other members of Congress earlier this month, Reps. William Jefferson (D-La.) and Bill Brewster (D-Okla.) said that without such a provision, "vast numbers of health professionals risk being locked out of the...managed-care market." The congressmen contend the provision would not have adverse effects because providers would have to abide by the plans' reimbursement and quality rules.
The issue is a deeply divisive one for providers because many of the providers seeking entrance to the health networks are minorities or providers in rural and inner-city areas.