Committee adopts working document for health-insurance reimbursement bill with lower minimum rate The committee adopted a committee substitute for SB 121 changing the proposed minimum insurer reimbursement to 345% of Medicare's fee schedule, includes network adequacy and audits, and set the bill aside for further consideration with an effective date of Jan. 1, 2027.

Alaska's Senate has adopted a new health insurance bill that lowers minimum reimbursement rates to 345% of Medicare while ensuring network adequacy and compliance audits.

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#AK #AccessToCare #InsuranceReform #CitizenPortal #NetworkAdequacy #AlaskaHealthcare

Committee hears staff briefing on Medicaid post-acute network standards; hospitals and insurers urge standards to reduce discharge delays Staff explained SSB 5124 would require the Health Care Authority to adopt network adequacy standards for nursing homes and inpatient rehab facilities with compliance deadlines in 2028; hospital and health-system witnesses supported the measure, citing costly single-case agreements and delayed discharges.

Washington's Senate Bill 5124 could revolutionize post-acute care by setting vital standards for timely discharges from hospitals, tackling the costly delays that affect patient recovery.

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#WA #PatientDischarge #CitizenPortal #MedicaidReform #NetworkAdequacy

Marcus Johnson Discusses Network Adequacy and Provider Access in State Care System Johnson highlights provider availability and efforts to combat fraud in behavioral health.

Arizona's healthcare landscape is evolving, with officials emphasizing the critical need for network adequacy and the fight against fraud to ensure every resident has access to quality care.

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#AZ #CitizenPortal #NetworkAdequacy #ArizonaHealthcare #PublicHealth #FraudPrevention

Network Inadequacy and Administrative Complexity: Searching for in-network mental health care or diabetes care with marketplace insurance - Public Agenda 9.7.23 Subscribe How difficult is it for people with marketplace insurance to find in-network health care providers, and how do delays and challenges in accessing care affect people’s lives? This…

Check out research from @publicagenda.bsky.social on how difficult is it for people with to find in-network mental #healthcare providers and how delays and challenges in accessing care affect people’s lives buff.ly/lEpqtnh #healthcare #healthpolicy #networkadequacy

Insurance carrier to repay patients, fix provider directory in NY settlement The state imposed a $250,000 penalty on MVP Health and asked it to provide restitution for enrollees hurt by inaccurate directory entries.

"New York state officials have negotiated a corrective action plan agreement with... MVP Health Plan after having trouble finding any mental health care providers in the plan's directory who were accepting new patients." #healthcare #healthpolicy #networkadequacy
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<em>Health Services Research</em> | AcademyHealth & HRET Journal | Wiley Online Library Objective To understand how Medicare Advantage (MA) networks impact utilization patterns and plan choices, using the 2019 discontinuation of MA 1876 Cost plans as a natural experiment. Study Setti...

"We find evidence of adverse selection among enrollees of discontinued Cost plans in 2019." #MedicareAdvantage #AdverseSelection #NetworkAdequacy onlinelibrary.wiley.com/doi/full/10....