Indiana patients to get reminder: Pay your doctors

A state legislative committee also will study the cost of requiring insurers to honor assignment of benefits.

By Emily Berry — Posted June 4, 2009

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Indiana patients who receive reimbursements for out-of-network care from their health insurance company also will receive a bold-faced reminder that they should use that money to pay their physicians.

A law that takes effect after Sept. 30 requires insurers to include the notice -- in at least 24-point bold type -- with any direct patient payments that cover claims for out-of-network care.

The legislation also calls for the state's health finance commission to study the potential cost of requiring insurers to honor assignment of benefits and pay both network and out-of-network physicians directly. It also requires the commission to study the impact of "open-access clauses," contract provisions that bar a physician from capping the number of an insurer's enrollees he or she sees.

The Indiana State Medical Assn. had hoped that the original version of the bill, which would have required insurers to honor assignment of benefits for out-of-network physicians, would pass during the recently ended legislative session, said Mike Rinebold, director of government relations for ISMA.

State Rep. Matt Lehman, an insurance agent from Berne, was among the legislators who drafted the final version of the bill in conference committee and was against requiring assignment of benefits.

"I'm a firm believer in the network system working," he said. Lehman said he thought adopting the bill as originally written would have weakened that system.

Rinebold said both supporters and opponents are hoping that the study will give skeptical lawmakers a clear sense of what such a requirement would mean for insurers, doctors and patients, and convince them to support it.

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