Any Willing Provider Law

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Any Willing Provider Law

In health care, a law requiring an insurer or a managed care organization to allow policyholders to receive treatment from any provider willing to accept the fee the insurer offers, even if he/she is not in the insurer's network of approved providers. About half of U.S. states have any willing provider statutes.
References in periodicals archive ?
During the NACDS RxImpact Day on Capitol Hill, the NACDS board met with acting CMS administrator Andy Slavitt to discuss the Part D rule, MTM eligibility and the any willing provider provision.
Inadequate Legal Protection State regulation of MCOs in the form of Any Willing Provider laws (AWP) provides little protection for NPs.
There is also reason to believe that any willing provider laws were not actively enforced during the time period studied by the authors because of a court order in 1997 blocking Arkansas' broad-based any willing provider law, passed in 1995 (Crowley 2003; McLean and Richards 2003; Bleed 2004a).
The potential of the enforcement of any willing provider legislation could have a negative effect on profitability and operations as ABCBS' ability to negotiate reimbursement rates could come under additional pressure.
We believe that the PBM [pharmacy benefits management] payments, PBM audits and MAC [maximum allowable cost] pricing are major issues in the market right now, and we are actively working to ensure any willing provider legislation, fair audit legislation and fair reimbursement for services--especially in the light of the new health care law.
During her 11-year tenure with the Federation, Hart was responsible for lobbying Congress on such major healthcare issues as Medicare and Medicaid, tax and labor law, antitrust, any willing provider, and unitary drug pricing.
He said forcing GPs to tender contracts to any willing provider may destabilise health economies and fragment care for patients.
Several states have enacted so-called any willing provider laws banning closed or preferred networks and enabling any pharmacy to participate in the network if it accepts required conditions and the stated reimbursement fees.
Members of the American Managed Care Pharmacy Association (AMCPA) have vowed to continue to oppose unitary pricing proposals as well as so-called any willing provider laws.