:: PPO’s Come Under State Scrutiny

State insurance regulators have taken action against a silent PPO, fining Great-West Life & Annuity Insurance Co. $8,000 for inappropriate physician discounts on claims.

“TDI Fines Silent PPO” Texas Medical Association News

The problem of silent PPO’s is a far underreported issue in the healthcare delivery system.  Texas is doing something about it. 

 HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that PPOs operating in Texas may soon be required to register with the Texas Department of Insurance.   Future regulations may give the Texas Department of Insurance authority over PPOs engaging in illegal practices.  Currently, the Texas Legislature has provided the Department of Insurance with the ability to study the lack of PPO regulation, but it has not granted it the ability to effectively regulate PPOs.

This would be a substantial aid to health care consumers and health care providers as well.