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Hospitals seek limit on insurer notices during contract talks; insurers warn proposal could politicize negotiations
Summary
The Insurance Commissioner proposed standardized member notices and a small number of public comment hearings when a provider‑insurer contract termination would affect 1,000+ covered lives. Hospitals supported a public forum; carriers said mandatory hearings and extra approval steps risked revealing proprietary negotiating positions and complicating continuity processes.
Insurance Department staff told the committee they had drafted language after high‑profile disputes to make consumer notices factual and to provide a forum for public comment when network terminations would affect many covered lives. Commissioner DJ Betton Court said notices sometimes read like campaign pieces and can inflame negotiations.
Hospitals including St. Joseph’s said the provision would help patients understand access and timelines. "When patients receive a notice that their provider may go out of network, it can be a sentinel event for someone with chronic care needs," said John Jerich, president of St. Joseph Hospital.
Carriers including Anthem said they already are required to notify members and provide continuity of care; they opposed mandatory departmental approval of member notices and additional hearings, arguing existing rules are sufficient and that the proposal could hamper confidential contracting. Anthem said notices they send are factual and include information members need to find alternate in‑network providers.
The Insurance Department and the bill sponsor indicated the draft will be refined in subcommittee to narrow scope (the draft currently targets terminations affecting 1,000+ covered lives) and to avoid imposing excessive procedural burdens on routine contract renewals.
