Specialty Health Network Model Law

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Medicaid Managed Care Network Adequacy & Access: …

(6 days ago) WEBCurrent federal rules require states to establish network adequacy standards for specified provider types including primary and specialty care (adult and …

https://www.kff.org/medicaid/issue-brief/medicaid-managed-care-network-adequacy-access-current-standards-and-proposed-changes/

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Regulation of Health Plan Provider Networks Health Affairs

(Just Now) WEBHealth insurance plans with limited networks of providers are common on the Affordable Care Act's (ACA's) health insurance Marketplaces. Recent studies have found that these "narrow network" plans

https://www.healthaffairs.org/do/10.1377/hpb20160728.898461/

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Network Adequacy - National Association of Insurance …

(3 days ago) WEBLast Updated 6/1/2023. Issue: Network adequacy refers to a health plan's ability to deliver the benefits promised by providing reasonable access to enough in-network primary …

https://content.naic.org/cipr-topics/network-adequacy

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Health Insurance Network Adequacy Requirements - National …

(4 days ago) WEBHMO network adequacy requirements: 30 miles for primary care and general care hospital. 75 miles for specialty care, special hospitals and single health care plan physicians or providers. PPO network adequacy requirements: 30 miles in non-rural areas and 60 miles in rural areas for primary care and general hospital care.

https://www.ncsl.org/health/health-insurance-network-adequacy-requirements

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Network Adequacy Standards and Enforcement KFF

(5 days ago) WEBHealth plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences …

https://www.kff.org/affordable-care-act/issue-brief/network-adequacy-standards-and-enforcement/

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CMS Releases Final Rule for 2024 Qualified Health Plans, …

(7 days ago) WEBOn April 17, 2023, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued the final Notice of Benefit and …

https://www.appliedpolicy.com/cms-releases-final-rule-for-2024-qualified-health-plans-strengthening-network-adequacy-standards-and-expanding-consumer-access/

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RE: Comments by the Alliance of Specialty Medicine on the …

(7 days ago) WEBBenefit Plan Network Access and Adequacy Model Act (“the Model Act”). The Alliance is a coalition of medical specialty societies representing more than 100,000 physicians and surgeons dedicated to the development of sound federal health care policy that fosters patient access to the highest quality specialty care.

https://www.aans.org/pdf/Legislative/ASM%20Network%20Adequacy%20Model%20Act%20FINAL.pdf

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A state-by-state fix for network adequacy issues?

(6 days ago) WEBLast week, the NAIC unanimously voted to adopt the Network Adequacy Model Act – draft legislation that states can use as a foundation for enacting a state law …

https://www.healthinsurance.org/blog/a-state-by-state-fix-for-network-adequacy-issues/

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Ensuring Compliance with Network Adequacy …

(Just Now) WEB(NAIC) developed a model state network adequacy law for managed care plans.12 Health plan networks broadened for a few years, but when premiums began to increase …

https://www.urban.org/sites/default/files/publication/88946/2001184-ensuring-compliance-with-network-adequacy-standards-lessons-from-four-states_0.pdf

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Network Adequacy: What Advocates Need to Know

(Just Now) WEBpersons requiring advanced technology or specialty care Although the Model Act, which has not been updated since 1996, applies to all managed care plans such as health …

https://communitycatalyst.org/wp-content/uploads/2022/11/Network-Adequacy_what-advocates-need-to-know_FINAL-01-28-14.pdf

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Reforming State Regulation of Provider Networks: Efforts at the …

(4 days ago) WEBAlmost two decades ago, the National Association of Insurance Commissioners (NAIC) adopted a model state law to regulate the adequacy of health …

https://communitycatalyst.org/posts/reforming-state-regulation-of-provider-networks-efforts-at-the-naic-to-re-draft-a-model-state-law/

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State of California—Health and Human Services Agency

(8 days ago) WEBThe Medicaid Managed Care and CHIP Managed Care Final Rule (Final Rule) establishes network adequacy standards in Medicaid and CHIP managed care for certain providers and provides flexibility to states to set state specific standards. California currently has network adequacy standards in place that meet many of these requirements.

https://www.dhcs.ca.gov/formsandpubs/Documents/FinalRuleNAStandards3-26-18.pdf

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Regulators Urge Broader Health Networks - The New York Times

(2 days ago) WEBHarvard researchers reported last month that nearly 15 percent of health plans in the federal insurance marketplace “completely lacked in-network physicians for …

https://www.nytimes.com/2015/11/09/us/regulators-urge-broader-health-networks.html

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Insurance commissioners publish first draft of network adequacy …

(3 days ago) WEBThe model law applies to all forms of health insurance, including qualified health plans, health maintenance organizations, and preferred provider organizations, …

https://www.mdedge.com/obgyn/article/88895/practice-management/insurance-commissioners-publish-first-draft-network-adequacy

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Home Specialty Health Network

(2 days ago) WEBAt Specialty Health Network by Shoppers™, A Commitment to Our Clients Means: Working collaboratively to understand patient and prescriber needs. Planning and …

https://www.sdmshn.ca/

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Access to Medi-Cal Specialty Mental Health Services: Network …

(3 days ago) WEBNational Health Law Program May 2023. 1. Access to Medi-Cal Specialty Mental Health Services: Network Adequacy Requirements and Other Beneficiary …

https://healthlaw.org/wp-content/uploads/2023/05/Access-to-Medi-Cal-SMHS_5.2023.pdf

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Access to Medi-Cal Specialty Mental Health Services: Network …

(2 days ago) WEBMedi-Cal covers Specialty Mental Health Services (SMHS) for beneficiaries who need them. In California, County Mental Health Plans (MHPs) are responsible for providing SMHS to Medi-Cal beneficiaries of all ages. This issue brief analyzes the legal requirements that require MHPs to ensure Medi-Cal beneficiaries’ access to SMHS and maintain …

https://healthlaw.org/resource/access-to-medi-cal-specialty-mental-health-services-network-adequacy-requirements-and-other-beneficiary-rights/

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LOCAL HEALTH DISTRICTS DISTRICT MODEL BY-LAWS …

(7 days ago) WEBMinistry of Health, do by this Order set out the terms of the Model By-laws to be used by Local Health Districts constituted under section 17 of the Health Services Act 1997 and …

https://www.health.nsw.gov.au/legislation/Documents/lhd-shn-model-by-laws.pdf

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California: Disability Advocacy - National Health Law Program

(3 days ago) WEBFabiola Carrión, Amy Chen, Abigail Coursolle, Alicia Emanuel, Héctor Hernández-Delgado, T. Nancy Lam, Kimberly Lewis, Carly Myers, Alexis Robles-Fradet, Skyler Rosellini, and …

https://healthlaw.org/california-disability-advocacy/

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Chiropractic & Physical Medicine Services Program Frequently …

(6 days ago) WEBMouse over Eligibility & Benefits and select Eligibility & Benefits Inquiry. If you do not have access to NaviNet, you may obtain member benefit information by calling Physician …

https://www.horizonblue.com/sites/default/files/2019-07/ASH_External_FAQ.pdf

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LOCAL HEALTH DISTRICTS DISTRICT MODEL BY-LAWS …

(2 days ago) WEBSPECIALTY HEALTH NETWORK– MODEL BY-LAWS PURSUANT to sections 39 and 60 of the Health Services Act 1997, I, Elizabeth Koff, Secretary of the Any motion to …

https://www.swslhd.health.nsw.gov.au/pdfs/BoardMinutes/Health_Service_Act_1997.pdf

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Model Law: Health Data Governance Principles

(1 days ago) WEBThe Model Law is informed by equity and rights-based principles, among other international, regional and national commitments and best practice. Transform …

https://healthdataprinciples.org/modellaw

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Care Coordination Model Increases Primary Care Follow-Up Access

(3 days ago) WEBThis all amounts to a relative 56.5 percent increase. The model of care also increased access to durable medical equipment within 180 days, marking a 12 …

https://www.techtarget.com/patientengagement/news/366584341/Care-Coordination-Model-Increases-Primary-Care-Follow-Up-Access

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California: Services - National Health Law Program

(2 days ago) WEBFabiola Carrión, Amy Chen, Abigail Coursolle, Alicia Emanuel, Héctor Hernández-Delgado, T. Nancy Lam, Kimberly Lewis, Carly Myers, Alexis Robles-Fradet, Skyler Rosellini, and …

https://healthlaw.org/california-services/

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