NADP’s Commission on Advocacy Policy rated network adequacy as one of the top two priorities for this year (tied with dental loss ratio). As such, the Government Relations Workgroup now has a specific Dental Networks Subgroup, which is reviewing current proposed legislation and working with state agencies as they start to implement network regulations.
NADP has participated in meetings in New York, Maryland and North Carolina, while ongoing discussions are also occurring in Oregon and Tennessee. North Carolina’s Department of Insurance is currently working towards regulating network adequacy and has requested stakeholders provide specific metrics in which they can measure access within a carrier’s network to enhance their current requirements. NADP’s Dental Networks Subgroup is working towards determining what specific metrics should be recommended, as only Medicare Advantage and a few states currently require dental network metrics. On the medical side, health plans have had to meet specific person-to-provider or geographic ratios as part of their accreditation. NADP will need to provide dental network metrics to North Carolina at their next meeting at the end of July.
Maryland is implementing HB 1318 with dental scheduled to be discussed in January of 2017. NADP will be coordinating with the Maryland Alliance of Dental Plans in formulating network recommendation in the fall of 2016.
As NADP policies and recommendation evolve this summer, we will be pulling them together as educational materials for carriers to utilize within their states as we expect this fall for state agencies to move quickly on network adequacy.
The Network Subgroup utilizes this document to track current activities, which is updated and posted within the Advocacy Open Forum of Dental Interact.