As the fifth anniversary of the Affordable Care Act approaches, the issue of “narrow networks” has been all over the news. The trend of health plans developing limited networks of healthcare providers to serve their enrolled patients has raised concerns. From a patient perspective, the primary concern is adequate access to healthcare services. From a provider perspective, the concern is one of being excluded from treating your own patients and economic constraint.
Managing partner and co-founder Harry Nelson was quoted in The Daily Journal on January 28th, 2015 discussing this topic:
Insurers create narrow networks to help slash premiums, but some attorneys say it leaves quality providers in the dark.
“If you’re included in the narrow network, there is an increase in patient flow, but that’s a small minority,” said Harry J. Nelson, Co-Founder and Managing Partner at Nelson Hardiman LLP. ” The majority are the have nots, the hospitals and physicians being excluded from these narrow networks and denied the opportunity to service the patients who want to be serviced by them.”
Nelson said his firm has sent roughly a dozen demand letters in the past year on behalf of provider clients to insurers on possible legal action for network exclusion. The insurers have compromised with his clients, he said, but the firm’s attorneys advise clients on possibly filing or joining in on similar lawsuits.
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