6/1/2017- Call to Action

Dear NVOS Members:

        As the final days of the session come to an end, two bills are still in play that threaten the way emergency services are compensated.  Both proposals, fashioned as “patient protection,” are brought by the insurance industry, including the health services coalition – a collection of self-funded insurance plans. Both proposals threaten the stability of the health care delivery system in Nevada, including our ability recruit and retain physicians to our state, threatening access to care for the very patients these bills purport to protect.  

AB382 requires emergency and on-call physicians who render out-of-network care to accept as payment in full a “reasonable rate” offered by the insurance plan.  If the Physician does not accept the offer, he or she may seek (in writing) a period of negotiation that is then followed by binding arbitration if negotiations do not result in a final acceptable payment.  The arbitration is paid for in half by the Physician and the arbitrator is required to consider the: 1) average amount negotiated by the third party for in-network care” (no word on how this would be determined or verified), 2) Medicare or 3) the usual and customary rate.   There is no threshold requirement to send bills to arbitration.  This will force physicians to expend resources, time and money to any arbitrate bills whether $10,000 or $15 or to accept whatever the insurance plan decides is reasonable payment.

The bill contains unacceptable metrics to assess payment for emergency services, and it includes an expensive and cumbersome process to arbitration.  Unfortunately, despite NSMA’s  best efforts, and those of our specialty group colleagues, to negotiate with the sponsor, the Physician concerns and requests have been brushed off and ignored.  AB382 has passed the Assembly and is being sent to the Senate for consideration.

AJR14  The sponsor of AB382 also introduced AJR14 which, if passed, would create a ballot question for a constitutional amendment, where the voters would decide if hospital charges for emergency services should be capped at 150% of the lowest rate accepted from a federal public insurer.  At this time, fees for physician services are not included in this joint resolution.  However, Joint Resolutions like this  do not cross the Governor’s desk, so there is no opportunity for a veto.  This would of a ballot question could be that rate-setting for emergency care is capped in the Nevada Constitution.

Until this week, we were hopeful that negotiations would leave us with a compromise that would protect patients, keep the health care market intact and support good faith negotiations of contracts.  Unfortunately, events lhave forced us in to a position where we need to oppose both bills straight our and we need your help!   The Legislative Session ends at midnight on Monday; what you can do includes: