Ohio Health Care Provider Joint Negotiation Act receives proponent hearing

 

The Academy of Medicine of Cleveland/Northern Ohio Medical Association’s President, Ronald A. Savrin, M.D. was first to give proponent testimony supporting House Bill 325, the Ohio Health Care Provider Joint Negotiation Act.  Representative Jim Trakas (R- Independence), the bill’s sponsor, provided sponsor testimony on the bill in early January to the House Insurance Committee.  Rep. Trakas emphasized that the public would benefit from this legislation as it would allow medical experts to determine what coverage would be medically necessary rather than the health insurers.

               

Dr. Savrin testified that “(health) plans present physicians with non-negotiable contract terms that a reasonable business person would never agree to” and that “as health plans continue to merge and consolidate, the decision-making authority over the health care of our patients will be controlled by a small group of managers.”

 

Dr. Savrin also noted that managed care plans “impose many unfair utilization procedures and transfer all patient care liability to the physician” and that “some insurance plans require physicians to agree to insure against any and all claims - and certain policies extend liabilities to persons outside the physician’s own practice.”  While conceding that, in some cases, managed care has encouraged physicians and hospitals to look for cost cutting opportunities, he also feels that the majority of their influence has been unfavorable.

 

Also providing proponent testimony was State Representative William Seitz, an antitrust attorney from Cincinnati, Ohio.  Rep. Seitz stated that “passage of the bill is necessary to level a very unlevel playing field that exists between our medical provider community and dominant managed care/insurer power buyers who have their own federal antitrust exemption.”

 

The bill is designed to provide a pro-active, market-driven solution to the imbalance of power in the health care market by waiving anti-trust laws and allowing medical providers to jointly negotiate patient care issues with insurance companies and HMOs.  The bill, which is modeled after legislation already in place in Texas, will represent the broad and common interests of physicians and patients on issues that affect access, quality and the cost of health care.  The bill will also allow for independent health care providers to join together to negotiate non-fee related contract terms with insurers.  Some of these terms include definition of medical necessity, patient referral standards and procedures, utilization review criteria, and payment methods and timing. 

 

The passage of this type of legislation has become a necessity in recent years due to the consolidation of insurance companies.  In the last six years, the number of insurance companies has dropped from 18 to six, creating an imbalance of power between health care providers and the insurance entities.  It has also been reported that more than 27,000 of the 140,000 bills introduced in state legislatures across the nation have been in response to the current state of the health care industry.

               

(The Academy of Medicine of Cleveland/Northern Ohio Medical Association’s mission is to support physicians in being strong advocates for all patients and promote the practice of the highest quality of medicine.  For more information regarding the Ohio Health Care Provider Joint Negotiation Act, please contact Elayne R. Biddlestone at (216) 520-1000, ext. 321.)