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Committee adopts Shield Act amendments to shield pediatricians from insurer quality‑score penalties
Summary
The Insurance Committee voted to advance House Bill 2,243 with two amendments; the bill would remove children whose parents opt out of vaccines from pediatricians' insurance quality scores to prevent financial penalties that can drive rural practices to dismiss families, sponsors and a witness said.
House Bill 2,243, presented to the Insurance Committee and advanced to Calendar and Rules, seeks to protect pediatricians from being financially penalized by managed care organizations whose quality metrics are tied to vaccine uptake. The committee attached two amendments before voting the bill forward.
Drew Schonacker, who said he served as the bill’s primary technical architect, told the panel that “we must shield our pediatricians from being financially penalized by insurance companies for medical decisions they do not control.” Schonacker said rigid MCO performance metrics tie 10 to 12% of a pediatric practice’s gross revenue to strict quality bonuses, forcing some practices to dismiss families who opt out of vaccines to avoid score drops and significant financial losses. He warned this dynamic has contributed to an access crisis: “Today, 4 East Tennessee counties have 0 certified pediatricians,” he said. The sponsor summarized the bill as removing patients whose parents opt out of vaccines from a doctor's quality score.
Committee members asked technical questions about the amendment language and fiscal impacts; the witness and sponsor said they had worked with stakeholders and expected no significant fiscal note. With no further debate the clerk reported the vote: 15 ayes and 1 nay; the measure moves to Calendar and Rules.
