Any Willing Provider Laws

State Freedom of Choice and Any Willing Provider Laws

AAMFT, along with patients’ rights groups and other allied organizations, has persuaded state legislatures to enact laws that allow clients to receive coverage from their insurance carriers if they receive covered mental health services from MFTs. There are two major types of laws that allow for MFT recognition by private payers: Freedom of Choice (Vendorship) and Any Willing Provider laws.

Freedom of Choice (FOC) laws require insurers and other health plans to reimburse providers listed in the law for providing services covered by the plan. FOC laws are also known as vendorship laws, direct access laws, any willing class of provider laws, and third-party reimbursement laws. Although varying in language and scope, these laws have the same result: allowing enrollees and beneficiaries to access the services of LMFTs. Although insurance companies may view these laws as “mandates,” these laws leave it up to their enrollees to determine whether to utilize the services of MFTs. In order for an MFT or an enrollee to receive reimbursement from a plan for services provided by the MFT, the service must be a benefit covered by the plan or a benefit recognized under the FOC law.

Currently, there are 28 states with FOC laws that include LMFTs: Alaska, California, Colorado, Connecticut, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, North Carolina, Oklahoma, Oregon, Rhode Island, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, and Wisconsin. Although these laws are fairly comprehensive, some of the FOC laws exempt certain types of plans from the scope of the law.

The “Any Willing Provider” (AWP) laws require insurers and other health plans to enter into contracts with all qualified providers who are willing to accept a plan’s terms and rates. The major difference between a FOC law and an AWP law is that a FOC law normally does not prevent a payer from having a closed network of providers whereas an AWP law prevents a payer from keeping providers covered by the law out of its network. Three states, Idaho, Vermont, and Wyoming, have comprehensive AWP laws that require insurers to reimburse any willing MFT who provides services covered under an existing plan.

 

State	Does state law require insurers to recognize MFTs?	Type of MFT mandated provider law	Comments
Alaska	Yes	Vendorship
California	Yes	Vendorship
Colorado	Yes	Vendorship
Connecticut	Yes	Vendorship
Florida	Yes	Vendorship
Hawaii	Yes	Vendorship	Enacted in 2007.
Idaho	Yes	AWP
Illinois	Yes	Vendorship	Enacted in 2008.
Louisiana	Yes	Vendorship	Enacted in 2008.
Maryland	Yes	Vendorship
Maine	Yes	Vendorship
Michigan	Yes	both	Vendorship & AWP laws.  AWP only applies to BCBS.
Minnesota	Yes	Vendorship
Mississippi	Yes	Vendorship
Missouri	Yes	Vendorship	Enacted in 2009.
North Carolina	Yes	Vendorship
Nebraska	Yes	Vendorship
New Hampshire	Yes	Vendorship
Nevada	Yes	Vendorship
Oklahoma	Yes	Vendorship	Enacted in 2008.
Oregon	Yes	Vendorship	Enacted in 2009.
Rhode Island	Yes	Vendorship
South Dakota	Yes	Vendorship
Tennessee	Yes	Vendorship	Enacted in 2010
Texas	Yes	Vendorship
Utah	Yes	both	Vendorship & AWP laws.  AWP only applies to PPOs.
Virginia	Yes	both	Vendorship & AWP laws.  AWP only applies to PPOs.
Vermont	Yes	AWP
Washington	Yes	Vendorship
Wisconsin	Yes	Vendorship	Enacted in 2009.
Wyoming	Yes	AWP

 

Notes:

1.  The term “insurer” includes commercial insurance companies, nonprofit health service corporations (state Blue Cross Blue Shield plans), and managed care companies (HMOs, PPOs, etc). 

2.  There are two types of laws that mandate recognition of MFTs:  Vendorship and Any Willing Provider (AWP) laws.  Most of the states with MFT mandated provider laws have Vendorship laws, which require insurers and other health plans to reimburse or otherwise recognize certain classes of providers who provide services covered by the plans.  AWP laws, on the other hand, require insurers to enter into contracts with all qualified providers who are willing to accept a plan’s terms and rates. 

3.  The laws in the states with broad MFT recognition generally apply to all state-licensed insurers.  However, some of these laws might not apply to all types of insurers.  

4.  Three states have both Vendorship and AWP laws that apply to MFTs.  In these states, the AWP laws only apply to one type of health care plan.

       5.  In the states with MFT Vendorship laws, the language of the laws can vary considerably.  Some laws require that insurers directly reimburse MFT for covered services.  Other laws require that insurers do not discriminate against MFTs as a class when selecting network providers.  For additional information on these laws, look at the other information on the AAMFT.org website or contact AAMFT staff.

SEHP Fact Sheet

All states offer some form of health benefits for eligible state employees and their dependents. Approximately 3.4 million state employees and retirees are covered by a state employee health plan. The AAMFT has developed the following fact sheet concerning these plans and the role of MFTs within these plans.

TherapistLocator

Over 15,000 marriage and family therapists are listed in TherapistLocator.net. The therapists are Clinical Members of the AAMFT, and as such must meet stringent training and education requirements established by the AAMFT. All AAMFT Clinical Members have agreed to abide by the AAMFT Code of Ethics. This Directory will assist you in locating a marriage and family therapist in your area. When seeking the services of a marriage and family therapist be sure to ask if your potential therapist is a Clinical Member of the AAMFT or look for the following logo identifying a Clinical Member of the AAMFT.

Visit the AAMFT TherapistLocator.net, a public service of the AAMFT. There you will find information about a range of problems facing today's families, and you can search for a qualified family therapist in your area.

State Job Classification

State governments are a major employer of mental health professionals. In general, a state job classification for MFTs must be created before state agencies can hire MFTs to serve as MFTs within state government. The following fact sheet developed by AAMFT provides a brief overview on how state job classifications are created, as well as information on current state job classifications for MFTs.