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February 26, 2014 at 07:40 AM
Washington state insurance regulators want more information about provider networks from all state-regulated health plans.
The regulators want carriers to give them monthly health care provider directory updates and disclose referral and prior authorization practices in the directory.
Plans that offer different “tiers” of in-network providers — such as wider tiers for enrollees who pay more out-of-pocket and narrower tiers for enrollees who pay less — would have to disclose which providers were in which network, and how much more patients would have to pay out of pocket to see the providers in the more wider tier.
The Washington State Office of the Insurance Commissioner included those provisions in a draft of proposed provider network regulations.
Emily Brice, a representative from the office, summarized the proposal in a written presentation included in a recent Washington Health Benefit Exchange board meeting packet.
The board runs the Washington Healthplanfinder state-based public exchange.
