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Posted in Regulatory and legislative updates, USA

US: CMS proposes Network Adequacy Standards for 2017 as State Regulators approve network access and Adequacy Model Law

On November 22, 2015, the National Association of Insurance Commissioners (NAIC) approved new standards designed to ensure that consumers have adequate access to doctors, hospitals, and other health care providers under health benefit plans that use provider networks. That action was the culmination of nearly two years’ work by state insurance regulators, with input from health insurance carriers, health care providers, consumer representatives, and others. The standards take the form of extensive amendments to an NAIC model law. Each state may choose to enact the amended model law, enact it with modifications, or disregard it entirely.

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