By NextBestFitPhase 1: Enactment & build · Step 1.6
Sign up providers & set participation rules
Months 6–18 · UHA Provider Enrollment; state licensing boardsDiscuss this step
Every licensed provider that wants to bill UHP signs one participation agreement. Participating providers accept UHP payment as payment in full (no balance billing). Opted-out providers may see patients privately but cannot bill UHP for anyone.
Legal vehicle
Universal Health Act, Title IV; extends Medicare's PECOS enrollment and opt-out rules (SSA §1802(b)).
Who does it
UHA Provider Enrollment; state licensing boards
When
Months 6–18
In this step
Tasks
6 tasks
Design choice & alternatives
1 decisions with alternatives
Trade-offs
2 pros · 2 cons · 2 trade-offs
Risks
3 risks with mitigations
What changes in the system
8 existing laws, programs, or institutions changed
Other countries
5 comparisons
Biggest risk for this step
Physician early retirement and opt-out. See risks.
Steps that depend on this one