Dear Senator Cassidy and Senator Collins,
As the authors of the Patient Freedom Act (S. 191) and as leaders in developing patient-focused health care policy,
the Alliance of Specialty Medicine writes to share health policy recommendations that we believe may be relevant
to the budget reconciliation process and health legislation pursued through regular order. In addition, attached
is information related to a physician survey conducted this year by the Alliance related to timely access to specialty
care.
Budget Reconciliation
Health care plans in the private market should provide timely access to specialty care. Key to this theme is
addressing the increasing issue of narrow insurance networks.
Ensure Network Adequacy
Patients face access to care barriers due to narrow health plan networks. Many times, unknown to patients,
entire specialties are excluded from health plans or the number and mix of specialists and subspecialists are
not adequate to meet the needs of the insured population. Networks should be sufficiently robust to ensure
that an appropriate number of specialists and subspecialists per enrollee are available. Additionally, network
directories should be updated in real-time and provide patients with clear, concise, and accurate information.
Finally, decisions to remove a physician from the network without cause should not be made in the middle of
a contract year. We urge you to ensure appropriate oversight to hold insurers accountable to ensure
patients have timely access to the right care, in the right setting, by the most appropriate health care
provider.
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Read full letter here
