BALTIMORE — The fourth in a series of public meetings related to the passage of House Bill 1318/Senate Bill 929 – Health Benefit Plans (Network Access Standards and Provider Network Directories) will be held Thursday, September 1, 2016 at the Maryland Insurance Administration, 200 St. Paul Place, 22nd Floor Francis Scott Key Room from 10 a.m. until noon. The Maryland Insurance Commissioner is tasked with adopting regulations to establish quantitative and, if appropriate, non-quantitative criteria to evaluate a carrier’s network sufficiency.

 

Topics to be discussed at the September 1st meeting include:
 
• Primary care provider-to-enrollee ratios. §15-112(D)(2)(III)*
• Provider-to-enrollee ratios, by specialty. §15-112(D)(2)(IV)*
• Should ratios be modified for providers who contract with more than one carrier?
• Should ratios be modified based on characteristics of the health benefit plan, such as having providers in centralized offices, or requiring a visit to a primary care provider for a referral?

 

*All statutory references are to House Bill 1318.

 

Information related to Network Adequacy can be found on the MIA website at www.insurance.maryland.gov under Quick Links in the section labeled Network Adequacy Regulation Information. Interested parties are encouraged to review these question(s) prior to the public meeting and include a detailed response in their testimony and/or written submission. Outside reports and studies are also posted on this webpage along with resources from other states.

 

If you plan to attend this meeting either in person or via teleconference, please RSVP to Lisa Larson. Written materials should be sent to Lisa Larson’s attention at networkadequacy.mia@maryland.gov.

For those interested parties that cannot attend in person, the conference call number for this meeting is: 866-247-6034 Passcode: 1573490062.

 

The remaining dates for the series of Network Adequacy public hearings are as follows:

 

• October 6, 2016
• November 3, 2016
• December 1, 2016
• January 5, 2017
• February 2, 2017

 

 

The Maryland Insurance Administration is an independent State agency charged with regulating Maryland’s $28.5 billion insurance industry. For more information about the Insurance Administration, please visit www.insurance.maryland.gov or follow us on Facebook at www.facebook.com/MDInsuranceAdmin or Twitter at @MD_Insurance.

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