TN anesthesiologists challenge health insurers over shrinking healthcare networks

The Tennessee Society of Anesthesiologists said health insurer Cigna is violating state law by removing providers and facilities from its network.

In 2024, the state began requiring insurers to maintain adequate provider networks and report any changes to the Tennessee Department of Commerce and Insurance.

Dr. Philip Houser, a board member of the Tennessee Society of Anesthesiologists, said Cigna removed about 760 providers across 50 facilities without the 15 days' notice required by the state. He said the cuts leave gaps in anesthesia care.

"The purpose of our complaint is more or less to just raise some awareness with TDCI so that they can see that there's an insurance company here in the state of Tennessee that's not following the currently passed legislation," Houser explained.

The complaint letter sent to the department noted state law allows health care providers to request a review of whether an insurer's network meets an adequacy standard. Public News Service reached out to Cigna Group via email for comment but has not received a response. The letter has not yet been made publicly available.

Houser noted the insurer's network changes limit patient access to care in some parts of the state. Patients may have to leave their geographical area to seek care from an in-network provider.

"The current legislation is designed to protect patients' access to health care providers in their geographical area," Houser emphasized. "Our complaint is intended to highlight a company that has failed in that obligation."

Houser explained Tennessee's network adequacy law is relatively new, and with any new legislation, additional clarification or rulemaking is often needed. He stressed their hope is either the current law will be better enforced or the rules surrounding it will be clarified.