Forcing Health Plans to Reimburse any Licensed Healthcare Provider

H.3021 and H.3867 would require that any health insurer who provides for directly payable benefits to preferred healthcare providers also allow directly payable benefits to non-preferred licensed providers who have a written assignment of benefits (a form typically filled out by the insured). Essentially these bills would force certain health plans such as HMOs that have a network of preferred health service providers, to cover the cost of health services performed by providers outside of that network. While this may give an individual insured by an HMO more choices, it’s also likely to drive up the costs of the plan. The more services and providers that are required to be covered by a plan, the more expensive we can expect that plan to be. Thus increasing insurance coverage requirements may actually harm many individuals by driving up their health insurance costs, or by making all the available health insurance plans too expansive to participate in at all.

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