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Robust ECP Standards Needed for Marketplace Inclusion

America’s Essential Hospitals submitted comments Feb. 25 to the Center for Consumer Information and Insurance Oversight (CCIIO) in response to its draft calendar year (CY) 2015 letter to health plan issuers in the federally facilitated health insurance marketplaces (exchanges). In its comments, America’s Essential Hospitals urged CCIIO to “require qualified health plan (QHP) issuers to offer contracts, in good faith, to every willing essential community provider (ECP) hospital in each county of the plan’s service area.” The association stated that including ECPs in QHP networks helps maintain patients’ access to services and continuity of care. In addition, America’s Essential Hospitals recommended that CCIIO ensure plan networks include hospitals that offer “all of the essential services relied on by low-income and medically undeserved patients.”

America’s Essential Hospitals, along with other provider groups, also submitted Feb. 25 a joint response  to the draft letter. The groups asked that  CCIIO improve ECP standards, stating that an ideal standard would require QHPs to contract with any willing ECP. They argued that “when expansions in health insurance coverage are not matched with strong network adequacy protections” patients may not be able to access “providers with the appropriate experience and expertise to meet their medical needs.”

Please contact Xiaoyi Huang, director of policy, at xhuang@essentialhospitals.org or 202.585.0127 with feedback or questions.

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