On April 2, 2002 the US Supreme Court ruled unanimously to uphold a Kentucky law known as an “Any Willing Provider Law”. Although this ruling did not get much press coverage, this ruling will have a profound effect on how health care is offered to the general public. Additionally, the law will have a considerable impact on the availability of chiropractic care in managed care programs.
This ruling upholds state laws that force HMOs to open up their doctor networks, allowing regulations in about half the states to give patients broader health care choices. The ruling is a blow to the managed care industry, which argued that closed networks are more cost-effective because doctors and hospitals that join agree to accept lower fees in return for a guaranteed stream of patients.
State “Any Willing Provider” laws basically allow all licensed doctors who agree to the terms of the HMO to become participating doctors in the HMO. This prevents HMO’s from limiting the number of doctors in their network. According to many state laws HMO’s are not allowed to discriminate against chiropractors. This ruling upholds those laws and opens up networks allowing more chiropractors to participate in various health plans.
The laws affect HMOs in all areas, but are particularly helpful to patients in rural areas or small towns, where health care choices are limited. In those areas, patients sometimes have to drive many miles to see an in-network health care provider. The Kentucky statutes were challenged by a group of HMOs and an industry trade association. The case turned on whether the laws regulate insurance, which states are allowed to police, or regulate employee benefits, an area reserved for Congress. The Bush Administration, had asked the court to uphold the Kentucky laws.