Officials in a number of states are pushing back against new health plans with narrow provider networks through regulatory action, legislation and other methods, according to a Kaiser Health News report.
The health plans — which will start offering coverage in January — have drawn criticism as consumers realize the healthcare providers they've been seeing might not be covered under the new policies, according to the report. Opponents say the plans could force patients to switch physicians or hospitals or travel long distances for care.
Insurers are offering narrow network plans in many states under the Patient Protection and Affordable Care Act, contracting with caregivers who agree to lower prices in expectation of more patients. For instance, health insurer Wellpoint has established narrow networks in its 14 Blue Cross Blue Shield affiliate states to support narrow network health plans sold through the insurance exchanges. WellPoint subsidiary Anthem Blue Cross Blue Shield is launching new, narrow-network insurance plans in states such as New Hampshire, Missouri and Maine.
Anthem has said shrinking its provider networks will provide high-quality care for a lower cost, but policymakers, consumers and providers left out of the networks have said the narrow plans will limit access to care and have sought regulatory and legislative ways to quash the limited provider networks.
For example, following a public hearing where hundreds criticized the Anthem narrow network, Maine Superintendent of Insurance Eric Cioppa decided in October that Anthem must restructure its plan to impose fewer restrictions on policyholders in southern and western Maine.
Additionally, Anthem's narrow network in New Hampshire has resulted in Frisbie Memorial Hospital in Rochester, N.H., taking legal action in the form of a request for a hearing with the state insurance department to review and reconsider the facility's out-of-network status.
More Articles on Narrow Networks:
Frisbie Memorial Hospital Takes Legal Action in Response to Blue Cross Network Exclusion
WellPoint Turning to Narrow Provider Network Strategy
Athem Blue Cross Confirms Missouri Exchange Network Will Exclude BJC