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 ?

"Handing over care to 'any willing provider' will undermine the NHS further by massively increasing the potential of company shareholders to fill their pockets at the expense of the NHS."

NHS OPS PRIVATISED VIA THE BACK DOOR; 200,000 procedures for profit in year

National Conference of State Legislatures, Health Policy--Federal Issues, Any Willing Provider, http://ncsl.org/statefed/health/AWP.htm.

The impact of pharmacy-specific any-willing-provider legislation on prescription drug expenditures

Twenty-three states currently have some form of "Any Willing Provider" (AWP) laws, which force insurance companies to contract with any willing provider willing to meet the insurer's terms and conditions (Levy, 2003).

Insurer policies create barriers to health care access and consumer choice

Several studies of any willing provider laws have shown that they increase the cost of care (Hellinger 1995; Jensen and Morrisey 1999; Rogal and Stenger 2001), and there have been a number of studies of the impact of specific patient protection laws (Hellinger 1996).

Commentary--assessing the impact of managed care patient protection laws: problems and pitfalls

In the unanimous opinion, the Court held that Kentucky's "any willing provider" (AWP) laws--which require managed care companies to accept into their networks any provider willing to abide by the network's terms--constitute regulation of insurance, and therefore are not pre-empted by the federal Employee Retirement Income Security Act (ERISA).

High Court ruling on ERISA is another blow to HMOs

As such, Vivius doesn't credential providers listed on its website, and in fact accepts any willing provider after validating licensure to practice in the state involved.

Defcon world: implementation of defined contribution will succeed in a competitive marketplace where providers set acceptable fees and risk levels, and consumers make informed choices based on personal values. (Profiles In Information Technology)

Other times, it's pro-pocketbook of doctors, as when the AMA defines quality of care as forcing plans to contract with "any willing provider." That kind of arrangement takes away a plan's ability to compete on quality, because it's no longer free to decide which doctors will be part of the plan.

What Doctors Don't Know

Proposed "any willing provider" statutes would compel MCOs to let any provider into the network who is able to meet its cost and quality criteria.

Managed care 101

From anti-trust and "any willing provider" laws to accreditation requirements, Medicare regulations, and utilization review procedures, CCH Managed Care Explained Plus arms professionals with details about a dizzying variety of laws, regulations, standards, and issues, including those relating to HCFA, OSHA, ADA, ERISA, STARK I, and STARK II.

Many medical CD-ROMs

There will also be growing emphasis on consumer choice, which would be helped by an 'any willing provider clause' allowing any provider willing to accept a managed care rate to be heard on issues of quality care without fear of retribution.

The ethics of managed care

In addition, a strong medical lobby in Florida is seeking "'any willing provider' protection," added Mr.

The health care reform wrangle

Many states are passing "any willing provider" laws, which require preferred-provider networks to accept any care provider who's willing to abide by their pricing constraints.