Alaska health care providers sue to keep state rule mandating minimum payments for care

A group of Alaska health care providers has sued the state government, seeking to keep in place a state regulation that sets a floor for how much private health insurance plans pay for out-of-network services.

The Alaska Division of Insurance plans to repeal the rule effective Jan. 1. The regulation, which has been in place since 2004, applies in situations where a private insurance plan is paying for health care delivered by someone outside of its network of providers.

Without the rule, “there’s no incentive whatsoever” for insurers to negotiate with providers, according to Dr. John Morris, who chairs a coalition of doctors that, along with other provider groups, filed the lawsuit Monday in Anchorage Superior Court.

The rule requires that out-of-network providers be paid at a level equal to the 80th percentile of charges billed by all providers for a service. For example, if five providers billed for a service, an out-of-network provider must be paid at a level equal to the second-highest of the five.

Read more: https://alaskabeacon.com/2023/11/25/alaska-health-care-providers-sue-to-keep-state-rule-mandating-minimum-payments-for-care/