Testimony in Support of H. 938 An Act Relative to Health Care Consumer Protection

Type:  Testimony 


Chairman Buoniconti, Chairman Koutoujian and members of the Committee, I would like to submit testimony in favor of a bill that I have filed, H. 938 An Act Relative to Health Care Consumer Protection. This legislation is important because it reflects a commitment from the 2004-2005 Legislative Session to do no harm in the streamlining of the credentialing process for which health plans verify health care provider credentials. Our goal this session is to have the advanced practice nurses and other auxiliary health care providers such as social workers, licensed mental health counselors, psychologists and others included as appropriate users of this proposed form and outlined process.
As many of you know, in addition to my work here in the State House, I am a practicing psychiatric clinical nurse specialist. Psychiatric clinical nurse specialists are considered by the Massachusetts Board of Registration in Nursing to be advanced practice nurses. In addition to medical physicians, advanced practice nurses, including nurse practitioners, nurse anesthetists and nurse-midwives, as well as other health care professionals such as those mentioned previously, podiatrists and chiropractors are credentialed by health insurance plans, non-profit hospital service corporations, medical service corporations, health maintenance organizations and preferred provider arrangements in order to be part of the covered network for consumers. 
Streamlining the credentialing process for all providers promotes competition and better care among health care professionals. The Federal Trade Commission together with the Department of Justice issued a report in July 2004 regarding improvements to the distribution of health care in America. The report goes as far as to say that current policies as they exist in Massachusetts hinder the development of new forms of competition among providers and bar new entrants from participating in the pool.
In the 2004-2005 Legislative Session the Senate engrossed two versions of the credentialing bill—one as an Outside Section to the FY04 budget that would have streamlined the credentialing process for all health care providers and the other, filed on behalf of the Massachusetts Medical Society and others which credentialed physicians only. Many states, including Louisiana and Illinois, have taken an approach to streamline the process for all health care providers. As far as I know, no state has singled out physicians only for the expedited credentialing process. States that have codified the credentialing verification process have seen the value of incorporating a clear definition of credentialing in the statue as well as ensuring the appropriate government oversight of the process. My intent is to bring together providers and health plans to establish common goals, criteria and oversight for the credentialing process.
As an advanced practice nurse, I know first hand the difficulty providers have becoming credentialed by various health plans. If we are to streamline the process, as we should, we must be sure that we clearly define the purpose for credentialing and that we create a better system for all health care providers. We must avoid any language that creates the potential for anti-competitive actions.
Thank you for hearing my concerns on this issue. I strongly encourage the Committee, at minimum, grant the legal protections afforded in H. 938 a favorable report.