In its meeting
later this week, the National Association of Insurance Commissioners
(NAIC) Executive Committee will consider approving proposed amendments
to its Network Adequacy Model Act
(Model #74). The amendments are the result of over a year’s work with
weekly conference calls of the Regulatory Framework B Task Force and a
the Model would expand the scope of the Model from just managed care to
include network plans. There are new sections on provider directories
and out-of-network providers at in-network facilities to address
“surprise bills” or balance billing.
NADP and DDPA
participated on the NAIC calls and were able to establish specific
exemptions for dental plans; however, there are particular sections that
continue to concern dental carrierss which will need to be closely
monitored as the Model is introduced within various states. If approved
by the NAIC Executive Committee this Saturday, NADP and the Government
Relations Workgroup (GRW) will be poised to respond and provide insight
on the Model from the dental perspective as it progresses to the state
legislatures and regulatory agencies in 2016.
A huge thank
you to the NADP Dental Network Workgroup, an ad hoc working group which
was formed to evaluate each NAIC and stakeholder proposal and met twice
weekly to respond quickly to the NAIC model.