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CMS Responds to Network Adequacy Concerns
Federal regulators are trying to set expectations and a tentative schedule for public exchange plans in 2015; they're also proposing a new approach to network adequacy and essential community providers, after complaints from consumers and providers in a few markets.
Federal regulators are trying to set expectations and a tentative schedule for public exchange plans in 2015; they're also proposing a new approach to network adequacy and essential community providers, after complaints from consumers and providers in a few markets.
The last date to submit health plans for certification through either the state or federal rate review system will be Sept. 4, which will allow time for multiple rounds of applications and resubmission before certification is finalized Oct. 17, the Center for Consumer Information and Insurance Oversight wrote in a summary of various proposed and final rules.
Regardless of what state they’re selling in, insurers may have some new information to submit to the Centers for Medicare & Medicaid Services this summer. Regulators said they’re going to be asking for lists of all in-network and out-of-network hospitals, primary care, mental health and oncology providers, and determine whether they offer patients “reasonable access” in their service area.
Read the full story here: http://bit.ly/1bNfqva
Source: Healthcare Payer News
Dr Kathy Zackowski Discusses the Importance of Rehabilitation Research and Trials in MS
April 26th 2024Kathy Zackowski, PhD, National MS Society, expresses the inherent value of quality rehabilitation trials for broadening clinical understandings of multiple sclerosis (MS) and bettering patient outcomes.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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