Your article, “Who is on your Health Insurance Team,” (Oct. 18) discusses an interesting problem that some patients face when entering a hospital, but fails to discuss the most appropriate solution to solve the problem. 

The Illinois Department of Insurance (DOI) has regulations requiring insurance companies to have “adequate networks” so that the patients they cover have access to appropriate care.  Some insurers have failed to maintain adequate networks and thus increase the frequency of the use out-of-network physician services. We agree patients should not be caught in the middle and we support the DOI’ s effort to protect them when they have made every effort to go to an in-network hospital.

The solution to this problem is having insurance companies offer fair contracts to hospital-based physicians so that there are adequate coverage options for patients. In fact there are tens of thousands of these contracts in effect throughout the State of Illinois.  There are instances however, where some insurers do not offer fair contracts.   In these instances physicians must maintain their rights to refuse to sign these contracts so they can maintain a viable medical practice. 

House Bill 5085 should be amended before it receives any further consideration in the General Assembly.  In its current form it will unfairly treat physicians, favor the large insurance companies and do nothing to increase the protections already afforded patients by the rules and regulations of the Illinois Department of Insurance. 

Sincerely,

Steven M. Malkin, MD, FACP
President, Illinois State Medical Society