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network exclusion

Model law would update requirements for insurance carriers in the health insurance marketplaces, particularly regarding provider directories, mental health services, telehealth, and nondiscrimination.

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network exclusion

According to a study, 10 states had a high prevalence of networks that were considered narrow in their health insurance marketplaces, while 12 states did not offer any plans with narrow networks.

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network exclusion

Proposed rule would better align regulations with those for commercial, health insurance marketplace, and Medicare Advantage plans

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network exclusion

Feb. 20 final rule and letter to issuers outline benefit and payment parameters for 2016 health insurance marketplace plans

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network exclusion

The association submitted comments to CCIIO and NAIC calling for more robust standards for including ECPs in health insurance marketplaces.

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network exclusion

For 2015, each qualified health plan (QHP) network must include at least 30 percent (up from 20 percent in 2014) of all available ECPs in its service area to meet network adequacy requirements. CMS is also implementing a reasonable access review standard.

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network exclusion

America’s Essential Hospitals protects access to care among marketplace plans. The association urged CCIIO to ensure an adequate number of ECPs are included in QHP networks. It also asked CCIIO to ensure patients have access to all hospital services in their plan’s network.

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network exclusion

These FAQs further clarify the Nov. 4, 2013 FAQ, which stated that the U.S. Department of Health and Human Services encourages issuers to reject premium payments from third parties such as hospitals, other health care providers, and other commercial entities.

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network exclusion

Sen. Jeanne Shaheen (D-NH) urged the U.S. Department of Health and Human Services Secretary Kathleen Sebelius in a Jan 29 letter to “closely examine the provider network adequacy standards” for qualified health plans sold through health insurance marketplaces (exchanges).

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network exclusion

The Affordable Care Act establishes state-based and regional health insurance exchanges

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network exclusion

Siegel noted : some plan networks are only covering selected services, offering low rates for essential hospitals

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network exclusion

Letter urges HHS to place a special emphasis on robust essential community provider participation

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network exclusion

Survey results will help plan advocacy efforts and assist members with individual negotiations

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