A provider network administrator somewhere in the country is trying to set up a nursing home network aimed issuers of private long-term care insurance (LTCI) and their policyholders.
The statewide nursing home network would offer people covered by “participating payors” rate discounts.
Only private LTCI providers could by participating payors.
Officials at the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) approved a proposal for the private LTCI nursing home network in an advisory opinion.
A copy of the ruling is available here.
HHS OIG officials do not name the administrator or say what state it’s in, and they note the network organizer might have to go through other, separate regulatory review processes.
The network organizers told HHS OIG they would open the network to any willing nursing home care provider in a state that earned a quality rating of 3 stars or higher on the Centers for Medicare and Medicaid Services Nursing Home Compare website, if the facility agreed to give a participating payor’s insureds a minimum discount on use of a semiprivate room.