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Regulation and Compliance > State Regulation to post network size ratings in 6 states

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The Centers for Medicare & Medicaid Services (CMS) says will give health plan provider network size ratings in a “limited number of states” in 2017.

In those states, plan menus will give network size categories for adult primary care providers, for pediatricians, and for hospitals, according to a new CMS bulletin.

“The consumer experience is a priority for CMS, and the goal of the network breadth pilot is to help CMS understand how consumers make use of the network breadth information,” officials say.

Related: Medicare plans may face wave of network adequacy fines

CMS asked for the provider network information it will use to calculate the ratings in the 2017 exchange plan application template. CMS will tell issuers what network size categories their exchange plans fall into before the start of the 2017 open enrollment period, officials say.

The open enrollment period for 2017 is set to start Nov. 1 and end Jan. 31.

CMS, an arm of the U.S. Department of Health and Human Services, set up to handle Affordable Care Act public exchange enrollment in states that are unwilling or unable to handle enrollment themselves.

The new plan network size rating bulletin applies only to plans in the states, not to plans sold through the exchange programs in states that have their own state-based, state-run programs.


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