Tag: network adequacy

New Georgetown Report on Medicaid and Marketplace Network Adequacy

A recently published report from Georgetown’s Center on Health Insurance Reforms and Center for Children & Families finds significant differences in standards for network adequacy between Medicaid and Marketplace plans, as well as gaps in oversight. The authors share several recommendations for protecting enrollees’ timely access to health services.

Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: State Insurance Departments and Marketplaces

After the Biden administration issued the proposed 2023 “Notice of Benefit and Payment Parameters,” several hundred stakeholders provided feedback on the new set of rules governing the ACA’s marketplaces and health insurance standards. To better understand the impact of the proposed rules, CHIR reviewed a sample of stakeholder comments. For the third blog in our series, Rachel Schwab summarizes comments submitted by state departments of insurance and state-based marketplaces.

Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates

In the recently released 2023 “Notice of Benefit & Payment Parameters,” the Biden administration is proposing significant changes to the Affordable Care Act marketplaces. In the first of a three-part series, CHIR’s Emma Walsh-Alker and JoAnn Volk reviewed public comments from multiple consumer advocacy organizations about the impact of the new policies on marketplace beneficiaries. Reviews of comments from insurers and state marketplaces and insurance departments will follow.

Ensuring the Adequacy of ACA Marketplace Plan Networks

Following the Trump administration’s decision to roll back federal network adequacy standards for Affordable Care Act marketplace plans, the Biden administration signaled it will soon resume oversight, proposing new, quantitative standards as well as proactive compliance procedures. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Justin Giovannelli examines current state and federal approaches to network adequacy, and what would change under the new standards proposed by the Biden administration.

The Proposed 2023 Notice of Benefit & Payment Parameters: Implications for States

The Biden administration has proposed a range of new standards and policies for the Affordable Care Act’s health insurance marketplaces. In her latest Expert Perspective for the Robert Wood Johnson Foundation’s State Health & Value Strategies project, Sabrina Corlette breaks down provisions that are of particular importance to states.

Navigator Guide FAQs of the Week: Will My Plan Deliver the Care I Need?

Provider networks and prescription drug coverage are important consideration for consumers when choosing a plan. As part of CHIR’s weekly series highlighting FAQs from our updated Navigator Resource Guide, this week we discuss how to make sure your plan provides access to the doctors, prescription drugs, and culturally competent care that you need.

State Options Blog Series: Federal Regulators Relax ACA Health Plan Oversight, Creating Opportunities and Challenges for States

In the second of a multi-part blog series on state options in the wake of federal actions to roll back or relax Affordable Care Act regulation, Sabrina Corlette reviews the new approach to health plan management in the federally run marketplaces. She discusses the implications for consumers and what state insurance regulators may need in order to enhance health plan oversight.

Recent and Potential Regulatory Actions to Roll Back the ACA: State Options Blog Series

While members of Congress debate possible bipartisan actions on the ACA, the future sustainability of the ACA’s consumer protections and markets also depend on regulatory and administrative actions. CHIR’s Sabrina Corlette reviews a series of recent actions by HHS to recast the federal approach to health plan oversight and tees up an upcoming series of CHIRblog posts outlining options for states that want to retain some or all of the reforms adopted by the ACA.

Relaxing the ACA’s Regulations: Stakeholders Respond to HHS’ Request for Information: Part 1—Insurers

The U.S. Department of Health & Human Services asked this spring for public comments on potential changes to the Affordable Care Act. They received over 3,270 comments from a wide range of stakeholders. To better understand concerns related to the law, CHIR experts pulled a sample of comments from health insurers, state regulators, and consumer advocates. In Part 1 of this three-part series, Emily Curran reviews the recommendations of large and small insurers.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.