News
NADP is monitoring network adequacy regulations in many states. Following are recent highlights on this industry issue.
Colorado: NADP provided comments to the Colorado Department of Regulatory Agencies in response to their dental specific regulations
released last week. The agency requested quick feedback on two options
to measure dental network adequacy. NADP and other dental plans
recommended option 2, which is the Centers for Medicare and Medicaid
Services (CMS) standard from Medicare Advantage. NADP’s policy is to
recommend this standard when we anticipate a state will be progressing
dental specific metrics. NADP also provided input on marketing
disclosures and update documentation, while dental carriers also
submitted clarification on the essential community providers (ECP)
definition.
Idaho: The Idaho state legislature released an updated redlined version of their draft network regulations,
which did not include recommendations from NADP members. The guidance
somewhat parallels the National Association of Insurance Commissioners
(NAIC) Model Act and includes an Any- Willing-Provider clause, monthly
directory updates, and contacting enrollees when their provider (they
are seeing on a regular basis) leaves the network. They have not
proposed specific dental metrics.
North Carolina:
On Sept. 19, NADP and member companies attended a meeting as part of
the state’s ongoing series of network adequacy conversations held by the
Department of Insurance. The meeting brought together carriers,
providers and consumers and was presided by a professional facilitator.
The Department will now begin drafting network regulations with a
deadline to provide a draft to the Commissioner by December. As a
reminder, NADP provided comments early on in the process on specific portions of the NAIC Model Act the DOI was reviewing.
