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Improvements May Come to Provider Networks of Exchange-offered Plans

The federal and state insurance benefits marketplaces have provided Americans with another option for healthcare coverage, but one of the main issues many people have had with the plans are their narrow networks. According to The New York Times, however, these networks may soon widen.

The Times reported President Barack Obama's administration is working with state insurance regulators to create more robust standards regarding provider networks. According to the newspaper, state will be allowed to create additional regulations and standards on insurance networks. 

According to a blog on domestic policy by Reihan Salam for the National Review, narrow networks are now commonplace and are meant to be a cost control measure for insurers. The reason narrow insurance benefits networks are problematic is if patients need to receive care from a provider outside the network, such as during an emergency situation or when they are unable to find a physician in the network, they can be hit with large costs, often without their knowledge. New York is one state that has already taken action to prevent patients from receiving surprise bills, and providers must now communicate with patients about their insurance. The new standards may help to reduce this issue, making exchange-offered plans even more attractive.

National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Valerie Ortiz

Valerie Ortiz

Over the past 20 years, Valerie Ortiz has worn many hats at National Insurance Services. She currently heads up NIS’ Marketing Team where she helps to create and execute employee benefit communications based upon our public sector clients’ needs. Valerie brings order to the chaos and has a zeal for detail and a talent for organization.