Rheumatologists push back on feds’ association health plan proposal

March 23, 2018|Rheumatology News

A proposed rule defining association health plans has raised red flags for the American College of Rheumatology.

In particular, ACR is concerned that, if enacted, the proposed rule published by the Department of Labor on Jan. 5 could create access issues.

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The rule as proposed would allow employers to form an association health plan (AHP) based on geography or industry, allowing plans to serve employees in a state, city, county, or multistate metropolitan area, and even employees in an industry nationwide.

“There is a marked lack of current data available related to the risk profile of existing and potential associations and how those intersect with the individual and small group markets,” ACR said in a March 6 comment letter to the Department of Labor. “We believe that moving forward with new policies without the totality of evidence can be dangerous and potentially harmful to patients with chronic diseases.”

The college also noted that, “we especially have concerns regarding patient access to care in rural and remote areas of the United States.”

The organization suggested that the Labor department write regulations to ensure network adequacy, particularly for specialty care, and address other reforms related to prior authorization.

Significantly, ACR expressed concerns that a kind of economic discrimination could occur under AHPs.