Will the Silent PPO Model Law Help Medical Providers?

The National Conference of Insurance Legislators (NCOIL) convened last Fall to draft a model Silent PPO Law called the "Rental Network Contract Arrangements Model Act." This model Silent PPO Law should be read by all medical providers (and the provider's lawyers and medical auditors) who deal with PPOs.  http://www.ncoil.org/HomePage/2008/AdoptedRentalNetworkModel.pdf.

The same concerns addressed in the model law are discussed in detail in plain English in our book The Ultimate Provider's Guide to Silent PPOs.  I wish the NCOIL had allowed me to testify at any hearings they had on this issue.  I am most concerned about the practical meaning of Section IV of the proposed law entilted "Contracting Entity Rights and Responsibilities," which seeks to make the downstream accesser of discounts contractually obligated to the terms and conditions of your contract with the PPO.  A well intended concept but it would have been better to legislate basic "steerage" requirements in the model law rather than leave it to PPOs and discount providers to manipulate their contract language for their benefit.  If your practice does not negotiate the terms of its contracts with the PPOs, loose contract language (i.e. the "terms and conditions of the provider network contract") could cause you to lose a lot of money.  There is no mention of steerage in the bill, in any form, and the onus is still on your contract negotiator to figure all this out before a contract is signed.