‘Any Willing Provider' Bill Returns, This Time Without Wilson Off to Races

by Mark Friedman  on Monday, Mar. 31, 2014 12:00 am  

State Rep. Jay Bradford, D-Pine Bluff, has switched houses but not sides in the “any willing provider” debate. (Photo by Michael Pirnique)

A version of this article originally appeared in Arkansas Business on Jan. 31, 2005. It is being republished as part of Arkansas Business' 30th anniversary issue. You can access the digital edition for free here.

Arkansas’ “any willing provider” law was a product of the 1990s — which means, of course, that there’s a Nick Wilson story in there somewhere.

A bill that has occupied lawyers for a full decade might have been a mere blip in the state’s long legislative history had Wilson, the powerful and ultimately disgraced state senator from Pocahontas, not been so eager to get to the horse races on one particular day in February 1995.

The Patient Protection Act of 1995 requires insurance companies to pay the same benefits to any provider willing to accept the same terms as the incumbent in-network providers. But it has never been enforced and is now in the hands of the judges at the 8th Circuit Court of Appeals in St. Louis, where a ruling could be issued at any time.

Term limits would have deposed Wilson by now if that conviction for federal tax evasion hadn’t gotten him first.

But in other ways, 2005 is starting to look a lot like 1995: A tweaked version of AWP that its sponsor believes to be immune from legal challenge has been introduced in the current legislative session — for the same reasons that inspired the original sponsor. And it has raised the same objections from the same opponents as the 1995 version.

Backlash

By the early 1990s, “managed care” — closed networks of health care providers that were guaranteed access to more insured patients in exchange for discounted prices — had spread rapidly across the country in an attempt to slow the rapid escalation of health care costs.

Managed care had created “a pretty competitive market among the health care providers themselves in an attempt to come within a managed contract,” said Morril Harriman, executive vice president of the Poultry Federation. He was a state senator in 1995 and voted for AWP, a vote he now considers a mistake.

In Arkansas, managed care had been taken a step further. In 1993, market leader Arkansas Blue Cross & Blue Shield partnered with Baptist Health of Little Rock to form the health maintenance organization Health Advantage.

While some doctors and hospitals were eager to enter into contracts with insurance providers so they would have a steady flow of patients, “those that did not fall within some of the major managed care systems … felt they were treated unfairly,” according to Harriman.

So did many patients. Bill Gwatney, the car dealer who was then representing Jacksonville in the Senate, heard countless tales of sick constituents driving to Little Rock for treatment because going “out of network” was too expensive.

 

 

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