Could the Affordable Care Act bring back the GP?

[Negrodamus]

I was reading an article on reimbursement rates and someone posted this in the comments:

http://thomas.loc.gov/cgi-bin/query/F?c111:1:./temp/~c111tyusI6:e153494:

(a) Providers- A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.

(b) Individuals- The provisions of section 1558 of the Patient Protection and Affordable Care Act (relating to non-discrimination) shall apply with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage.

Will this provision have any major affects or is it a whole lot of nothing?

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[EctopicFetus]

FPs are fighting for more money. God bless em. GPs are done for because the work sucks.

 

[edmadison]

Yes, it means that NPs and PAs must be paid the same as physicians

-Ed

 

[3dtp]

I was reading an article on reimbursement rates and someone posted this in the comments:

http://thomas.loc.gov/cgi-bin/query/F?c111:1:./temp/~c111tyusI6:e153494:


Will this provision have any major affects or is it a whole lot of nothing?

If I were Kevin Weiss, I'd be worried. One of the biggest clubs the specialty boards have to enforce certification, time limited certs, maintenance of certification and the astronomical time sump and money sump these programs are is the threat of loss of insurance panel status which has marginalized those who do not complete board certs for over a generation.

The "any willing provider" clause does give the insurers leeway to set differential payment schedules based on creds. This could be used to maintain the status quo, but it does appear to be a chink in the armor. Now some hospitals are starting to grant creds waivers for those nearing retirement who have finally told the specialty boards to fly a kite and they risk loosing all their most senior and experienced docs.

 

[smq123]

Moving to Topics in Healthcare.