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- Oregon Pathologists Push Network Adequacy Amendment
Pathologists in Oregon and the CAP are working together to stop narrow health insurance networks from continuing to disrupt patient care.
The Oregon Pathologists Association (OPA), with support from the CAP and the Oregon Medical Association (OMA), urged an amendment to Senate Bill 822 (Heath Plan Network Adequacy) to establish network adequacy standards for health insurance plans subject to state oversight. The amendment calls to include pathologists, anesthesiologists, radiologists, and emergency physicians in the scope of any state requirement for health insurance plans to be evaluated by the state for network adequacy.
In its testimony, OPA stated: "Many health plans nationwide are engaged in exploitative business practices that seek to limit enrollee options by narrowing their specialist provider networks. These 'narrow networks' undermine quality of care and can create both geographic barriers to enrollee access and time delays in services provided, as is the case potentially with pathology and laboratory services." In conclusion, OPA urged that "the legislation be amended to include other physician specialty services, including pathology and laboratory services." The Oregon Radiological Society also submitted testimony supporting the OMA amendment of the bill.
If passed, the legislation would emulate other states such as Illinois, Georgia, and Tennessee, all of which have network adequacy laws requiring state scrutiny of health insurance plans, ensuring these physician specialty services are under contract at in-network facilities and hospitals.
The CAP will provide updates as additional information becomes available.