Rural healthcare at risk if we don’t hold health plans accountable

Guest Opinion//March 24, 2023

Cook, House, health care, bills, legislation, House — When a business provides a service, it expects to be paid accordingly and in a timely manner. However, that is not the case with healthcare. Commercial health insurance routinely downgrades and denies payment to healthcare providers, which means providers are left treating patients and not getting paid. My bill, HB2290 currently up for consideration in the Senate, is important for hospitals, physicians and patients. (Photo by Pexels)

When a business provides a service, they expect to be paid accordingly and in a timely manner. Common sense, right? Well, there’s one business where that doesn’t routinely happen— healthcare.

Commercial health insurance routinely downgrades and denies payment to healthcare providers, which means providers are left taking care of patients and not getting paid. That’s not a good business model, especially when lives hang in the balance. That is why my bill, HB2290 currently up for consideration in the Senate, is important for hospitals, physicians and patients.

Cook, health care, rural health care, hospitals, insurance, bills, patients, legislation — Rep. David Cook, R-Globe

For one hospital in my district, they’ve waited more than six months for a specialist to be credentialed with the commercial health plans. This means the specialist won’t see commercially insured payments because the physician and the hospital won’t be paid for the care they provide. Medicare requires that providers get credentialed in 10 days, but somehow these massive national health insurance companies can’t get it done for more than six months.

In my rural district, my constituents deserve to see healthcare providers in their own communities and not have to travel to Phoenix or Tucson. Rural providers cannot provide free care to their patients, and if the health plans continue to give them the runaround on payments, they’re at risk of not being able to provide any care at all.

Today, some business groups are opposed to this bill – it’s not clear why. HB2290 doesn’t add any new benefits that would increase costs – it just calls for increased transparency, promotes fairness and asks health insurance companies to do the reasonable thing and pay their bills.

David Cook is a Republican politician elected to serve in the Arizona House of Representatives from the 7th legislative district. He was first elected to the state House in 2016 and represents central and eastern Pinal County and southern Gila County.