US Supreme Court Opens Networks For Chiropractic
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
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.