Insurance commissioner to review most-favored-nation clauses

NEWS IN BRIEF — Posted Aug. 6, 2012

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Michigan’s insurance commissioner has notified the state’s health insurers that most-favored-nation contract clauses may violate state law. He ordered them to submit any contracts containing that type of language after Feb. 1, 2013, to the Office of Financial and Insurance Regulation for review.

A most-favored-nation clause typically requires that a hospital or physician group give a particular insurer the lowest rate, meaning that competing insurers can’t negotiate lower prices for care for their members. Under the July 18 order, any insurer who attempts to enforce such contract language after the February deadline without the department’s approval would be subject to censure by the state.

The U.S. Dept. of Justice and Aetna have sued Blue Cross Blue Shield of Michigan over the alleged improper use of most-favored-nation clauses, which the Justice Dept. and Aetna say have given the Blues an unfair market advantage.

A company statement from Blue Cross Blue Shield of Michigan said the company welcomed the insurance commissioner’s decision, in part because it believes the legality of most-favored-nation clauses is a state issue.

“We will continue to negotiate reimbursement with hospitals that is fair, recognizes hospitals for their efforts to improve quality and provides our customers with the most affordable pricing possible,” said Jeffrey Rumley, vice president and general counsel of the company.

Note: This item originally appeared at

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn