Insight, analysis & opinion from Joe Paduda
Employers and insurers decry the recent reform instituting PPOs in Illinois as ‘California Lite’. Plaintiff attorneys claim it will lead to undertreatment and negative consequences for claimants. What’s the real impact? The right answer is it’s a bit early to … Continue reading Illinois’ work comp PPO: what’s the real impact?
Read More...I’ve never had a guest post on MCM but an email from a colleague inspired me to ask if I could publish it not as a comment but as a post. The writer addresses the issues laid out in my … Continue reading What reformers and their opponents should know
Read More...PPO company Viant (owner of Beech Street and PPONext) will be acquired by larger PPO company MultiPlan. The announcement came last week; here’s the lead from the internal memo to employees: “After much thought and deliberation by our Board of … Continue reading PPO firm Viant acquired by MultiPlan
Read More...In Washington, it’s what between the lines that counts. Today is a prime example. The NYTimes’ article on the latest from the White House today was entitled “Obama Overrides Aide on Health Insurance ‘Public Option”. But reading the article, and … Continue reading The public option is on life support, and the prognosis is poor
Read More...Expect the Texas legislature to pass laws tightly restricting PPOs before the end of the biennial legislative session June 1. According to WorkCompCentral, the Senate is making considerable progress on a compromise bill that will closely follow the NCOIL model. … Continue reading Silent PPO legislation coming to a state near you
Read More...As the biennial Texas legislative session nears its end, it looks like the legislature may pass a bill that would have a dramatic effect on workers comp PPO networks. According to WorkCompCentral (subscription required): “HB 223 would regulate “discount brokers” … Continue reading Texas’ silent PPO legislation
Read More...PPOs, or Preferred Provider Organizations, have been around for a couple dozen years. They are networks of credentialed (with varying degrees of rigor) doctors, hospitals, and ancillary providers that have agreed to provide lower rates for ‘members’ in return for … Continue reading Why PPO litigation is increasing
Read More...The PPO world is about to get more complicated, and likely less profitable – for the PPOs. The National Conference of Insurance Legislators (NCOIL) has developed model legislation tightly regulating PPOs, legislation that looks to be on the docket in … Continue reading The taming of the wild west – PPO regulation is getting serious
Read More...Peter Rousmaniere has written a thoughtful, detailed, and quite accurate piece on the state of the workers comp PPO market. I recommend it highly.
Read More...Managed care execs at WC payers are getting increasingly nervous, and well they should be. There are major changes afoot in the WC managed care market. The consolidation at the top means that changes in policy and practice by the … Continue reading Is the WC PPO marketplace becoming a monopoly?
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