Our Wisconsin clients got quite a shock with their new Delta contracts for 2018. In these, there were provisions that would limit Doctors to referring to only specialists in the Delta network and would allow Delta to lease their provider list of the carriers. (So, you might sign-up for Delta, and then find you’re with a bunch of other PPO’s.)
Most disturbing was their insistence that Doctors send them fee schedules of other PPO’s that they participate with and agree to accept from Delta the lowest fee allowance they get from other PPO’s. This could have been a huge problem for dentists. I don’t think Delta could enforce it. Most Doctors that sign a PPO contract are required to keep the fee schedule confidential. So, the Delta contract, in effect ,asked Dentists to violate other contracts. I would think that other PPO’s such as MetLife, Guardian, etc., would have something to say about that.
Anyway, apparently the Wisconsin Dental Association rode to the rescue. All those clauses were taken away. “Back to normal”, for now. Good to see, but I always wonder when the next shoe will drop.