One-Pager Opposing SB 1723: Backdated HMO Referrals Undermines HMO Cost-Savings
TAHP opposes SB 1723 because it undermines the cost-saving mechanisms of HMOs and disrupts the delivery of coordinated care.
- This change has the potential to eliminate the lower-cost option that HMOs provide when compared to Preferred Provider Organizations (PPOs) and Exclusive Provider Organizations (EPOs).
- While SB 1723 does not eliminate referrals entirely, it creates a loophole that allows providers to backdate referrals up to 30 days.
- This has the same consequences as eliminating referrals, eroding the very foundation of HMOs.
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