"We're waiting to see in the next three weeks if CMS addresses the issue," says Holloway.
So far, the only guidance from CMS remains an April directive to insurers requiring that they notify "all potentially affected providers as soon as is practicable," though that language is not strong enough for Missouri's provider associations or the American Medical Association.
The letter from Missouri's provider organizations states "practicable" doesn't go far enough, saying it is "an undefined standard that is subject to wide interpretation by the health plans."
The remaining four issues on the Physicians Foundation Watch List for 2014 include some other repeats from 2013, such as concern that industry consolidation could lead to monopolization. Again, this fear is a result, though indirectly, of healthcare reform.
As more healthcare organizations merge and/or partner to achieve business efficiencies, small physician practices feel pressure to align with larger groups or organizations because they can't achieve the same value proposition as the bigger guys in town.