Yes, Virginia, there are holes Virginia's AWP law provides the best example, perhaps, of a statute riddled with holes. It's not, for several reasons. Fifth, the statute doesn't give rejected applicants the right to appeal. As if all these flaws aren't enough, Wade also points out that the state insurance commission has no authority to enforce the law. Virginia isn't alone.
Plans can make their credentialing criteria so extensive they weed out tons of providers.
Some physicians, however, are fighting back. Two Virginia podiatrists, a father and son who practice together, sued a health plan in federal court after their PPO applications were rejected. They claimed a violation of the state's AWP law. Rather than slog through a messy court fight, the plan quickly agreed to add them to its panel. That's a cynical way to try to discredit them.