Ark. Commissioner Says Guidance Needed on Health Care Law

The Arkansas insurance commissioner this week told lawmakers she needs guidance on enforcing a state law to allow people covered by health maintenance plans to see the doctor of their choice.

Insurance Commissioner Julie Bowman told lawmakers that legislation passed last year gave the Insurance Department power to enforce the 1995 so-called “any willing provider law.” A federal appeals court last year cleared the way for the enforcement of parts of the law and said it did not violate federal rules for employee health benefits.

“The law gives the Insurance Department a lot of authority and a lot of power to do things with this, but I don’t want to go too far or too quickly,” Bowman told the House and Senate public health, welfare and labor committees. “We don’t want to go beyond what you all intended with this legislation.”

Last year, the 8th U.S. Circuit Court of Appeals in St. Louis affirmed the rights of providers willing to accept the terms to participate in the health plans.

The panel, however, overruled a portion of U.S. District Judge James Moody’s decision that the law also covered self-insured plans.

Bowman told legislators that the department is hitting new ground with the law giving her the authority to enforce the law.

“We historically have not regulated medical providers’ terms and conditions with health insurers, and now we are actively implementing those things,” Bowman said. “Some of those have been easier than others. Many of these become very emotional issues, as you can imagine.”

Bowman told reporters after Tuesday’s hearing that’s she’s not necessarily pushing for legislation in the 2007 session to clarify her role, but said she wants some guidance from legislators.

“I don’t want to be that rogue insurance commissioner who goes beyond what is really appropriate,” Bowman said. “I want to go just far enough to protect the consumer to ensure the purpose, the intent of the legislation, so the consumer will have access to good competent providers.”