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November 05, 2015 at 12:44 PM
Two national groups that shape insurance laws and regulations are both finishing proposals that could affect minimum standards for major medical plan provider networks.
At the National Association of Insurance Commissioners (NAIC), the Health Insurance and Managed Care Committee has approved revisions to the NAIC’s Managed Care Plan Network Adequacy Model Act.
The NAIC’s executive committee and its plenary, the group that includes all NAIC voting members, could vote on the model revisions later this month, at the NAIC’s fall meeting in National Harbor, Md.
At the National Conference of Insurance Legislators (NCOIL), the Health, Long-Term Care and Health Retirement Issues Committee is preparing to vote on a Proposed Model Act Regarding Network Adequacy and Use of Out-of-Network Providers Nov. 12.
The NAIC and NCOIL began their projects in response to complaints, especially from providers, about the narrow provider networks some insurers have been using to hold down the cost of coverage, and to complaints from consumer groups, and insurance agents and brokers, about patients who thought they were using in-network care getting bills for out-of-network services.
See also: More skirmishes from the provider network war
