QHP Certification and New Network Adequacy Review Timeline
Love a good calendar? We do too! Whether you’re keeping up with the latest news on network adequacy requirements or you’re a busy professional who can’t afford to miss a deadline, we’ve got just what you need. Our sleek timeline highlights the important submission dates for issuers offering a Qualified Health Plan (QHP) on the […]
The Requiring Enhanced & Accurate Lists of Health Providers Act
Are enrollees receiving the healthcare services they were promised? Inaccurate provider directories and ghost networks have been longstanding concerns in the healthcare industry, particularly with mental health services. Recognizing the need for improvement, lawmakers have introduced new legislation to address inaccurate data and help seniors receive the care they purchased. The Requiring Enhanced & Accurate Lists […]
Network Adequacy and Provider Directory Accuracy Policy Updates
Looking for the latest updates on network adequacy and provider directory health policies? You’ve come to the right place. Let’s dive into the latest federal and state policy developments. Download Article Federal Policy Updates Regulators and policymakers are dedicated to strengthening the oversight process for Medicare Advantage, Marketplace, and Medicaid Health Plans, both at the […]
What You Need to Know About New QHP Certification
Staying on top of all the latest updates in the industry can be a real challenge. That’s why we’re here to break down everything you need to know about the Qualified Health Plan (QHP) certification and network adequacy compliance. Grab your favorite beverage and get ready to dive into the world of QHP certification and […]
Mark Your Calendars: Important Medicare-Medicaid Plan Network Submission Coming Up
Time flies when you’re managing a Medicare-Medicaid Plan (MMP) provider network. Before you know it, the network submission deadline is just around the corner—and we’re here to ensure your success. Get ready to take note of the important details! Network Submission Due Date Reminder Key Dates and Times Let’s dive straight into the specifics. The […]
Four Ways Regulators Prioritize Health Equity into Network Adequacy
In the pursuit of high-quality healthcare, it is essential to go beyond network adequacy metrics and prioritize health equity. In a conversation between Scott Westover, SVP of Network and Regulatory Strategy at Quest Analytics, Michael Conway, Colorado Insurance Commissioner, and Grace Arnold, Minnesota Department of Commerce Commissioner, we learned how these leaders are working together […]
The Growing Need for Accurate Provider Data
Gather around healthcare enthusiasts! The focus on accurate provider data is heating up and we have the inside scoop. From federal and state regulations to health policymakers, the buzz is gaining momentum. Keep reading to stay in the know. Current Activity to Ensure Accurate Provider Data What Provider Data Accuracy Rules are in place? Let’s […]
CMS Changes Network Adequacy Application Process for Medicare Advantage
NEW CMS NETWORK ADEQUACY REQUIREMENTS Demonstrate Adequate At the Time of Application 10-percentage Point Application Credit Letter of Intent to Contract CMS REINSTATES NETWORK ADEQUACY REVIEWS AS A CONDITION OF INITIAL OR EXPANDING SERVICE AREA APPLICATIONS Starting with the 2024 contract year (CY 2024) application cycle, Medicare Advantage organizations (MAOs) applying for an initial or […]
Predictions On The Proposed 2024 Exchange Rule – Part 3
https://www.youtube.com/watch?v=zp0aVnW2mxs What health policy trends are we watching? Let’s discuss! The third part of our latest Regulatory Review is here! Zach Snyder and Kate Deiters explore the different ways states are making the connection between health equity and network adequacy. REGULATORY REVIEW Predictions on the Proposed 2024 Exchange Rule Zach Snyder and Kate Deiters of […]
Predictions On The Proposed 2024 Exchange Rule – Part 2
Will Qualified Health Plans on the Federally-facilitated Marketplace see Appointment Wait Times added as a network adequacy requirement? Let’s discuss it! In Part 2 of our Regulatory Review, Zach Snyder and Kate Deiters continue to share our predictions for the proposed Notice of Benefit and Payment Parameters rule for 2024. https://www.youtube.com/watch?v=mH2jvCK9kGE APPOINTMENT WAIT TIMES AND […]
