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- Illinois Pathologists, CAP Support Network Adequacy Reform
The Illinois Society of Pathologists (ISP) and the CAP issued support for Illinois State House Bill 2580 that would requires network adequacy of pathologists and hospital-based specialists. The CAP continually advocates for states to require that health plans have adequate networks of pathologists and hospital-based physicians.
In a March 6 letter to Illinois State Rep. William Hauter, ISP President Rohit Gupta, MD, FCAP said that “The proposed legislation protects against health carriers’ deceptive practices to advertise and offer inadequate health plan networks to Illinois patients, including misrepresenting hospitals and other facilities as in-network, without adhering to requisite and rigorous department of insurance oversight to ensure enrollees actually have access to in-network hospital-based specialists at such facilities.”
Illinois would join several states with similar CAP-enacted statutory requirements for hospital-based specialist network adequacy, including Louisiana, New Hampshire, Virginia, and Washington State. Hospital-based specialist adequacy at in-network hospitals and facilities would be assessed by the state insurance department, including, but not limited to, pathologists, radiologists, emergency physicians, and anesthesiologists.
The CAP will continue to monitor the legislation and additional opportunities for network adequacy reform.