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- Oklahoma Pathologists Oppose Out-of-Network Bill
Pathologists in Oklahoma and the CAP are working together to oppose legislation that would establish a state benchmark for physician out of network payment.
The Oklahoma State Association of Pathologists (OSAP), with the support of the CAP, has communicated strong opposition to Senate Bill 1047. A hearing on the bill was held in the Senate Business and Insurance Committee on March 6. The bill passed unanimously from committee and awaits consideration by the full Senate.
As noted by OSAP: "of specific concern SB 1047, establishes a 'Minimum benefit standard' which means the eightieth percentile of all allowed amounts for the same or similar health care service furnished by an in-network provider or in-network facility as reported in an independent benchmarking database maintained by a nonprofit organization specified by the Insurance Commissioner. The 'Allowed amount' means the contractually agreed-upon amount paid by a health benefit plan to an in-network provider or in-network facility in the health benefit plan network."
OSAP further stated that: "This formula is highly adverse to the physician community and the medical delivery system. Tying physician and laboratory payment to a payment methodology under the exclusive and unilateral control of the health insurance industry will only serve to encourage health insurers to further slash contracted physician payment. This approach was knowingly rejected by the Congress when President Trump signed into law the federal No Surprises Act in 2020."
The CAP will continue to oppose the bill in collaboration with OSAP and update members as information becomes available.