Obama Administration Moves Forward with New Continuity of Care Protections—How Will They Affect Existing State Laws?

By Sabrina Corlette, Ashley Williams and Kevin Lucia

The Obama administration recently issued final regulations related to the standards and operations of the Affordable Care Act’s (ACA) marketplaces, including one that implements a new continuity of care protection for consumers in the federally facilitated marketplaces (FFM). Under this new provision, when a provider is terminated from a health plan network without cause, issuers must allow consumers in the middle of an active course of treatment to continue to be seen by that provider until the treatment is complete or for 90 days (whichever is shorter) at in-network cost-sharing rates. Issuers are also required to provide written notice of the provider’s termination 30 days prior to the effective date of the termination, or otherwise as soon as practicable, to all enrollees who are patients seen on a regular basis by the provider or receive primary care from the provider.

In a previous blog post for the Commonwealth Fund, CHIR researchers Sabrina Corlette, Ashley Williams and Kevin Lucia provided a 50-state overview of state continuity of care protections, and assessed how they compared to the federal proposal.

Now that the administration has finalized its continuity of care protections, the trio of researchers issued their final post for the series on continuity of care protections for the Commonwealth Fund. In this piece, they explain the new federal continuity of care requirements and provide an analysis of the rule’s impact, along with a 50-state assessment of which protections meet the new federal standards.To read the full analysis and view the interactive map, visit the Commonwealth Fund blog here.

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