Network Adequacy Regulations Information

Written submissions will be considered public documents and will be posted to the Maryland Insurance Administration website.


Any questions or comments on Network Adequacy Regulations can be sent to: networkadequacy.mia@maryland.gov

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Annual Filing

 

Annual Filing Instructions

Population Density by Zip Code

2019 Executive Summary Form Filings

Please note: the information contained in the executive summary forms provided below has not yet been reviewed by MIA staff for accuracy or completeness.  The preliminary information reported below may be subject to change after the MIA completes its review of the 2019 access plans.

 

2018 Executive Summary Form Filings
 

2019 Meeting Schedule

 

​Next Meeting

TBD

Location:

Maryland Insurance Administration
24th Floor Hearing Room
200 St. Paul Place
Baltimore, MD 21202

Scheduled Meetings:

Friday, November 15, 2019 - Cancelled - New Date TBD

Previous Meetings

November 5, 2019
Agenda

October 23, 2019
Agenda

2019 MIA Staff Questions To Interested Parties

 
The Maryland Insurance Administration is accepting comments on all aspects of the network adequacy regulations in COMAR 31.10.44. In addition to the questions posed in the October 23, 2019 meeting agenda, MIA staff would appreciate comments on the following:
 
In the definitions section in COMAR 31.10.44.02, should a definition for any of the provider types listed in the travel distance standards be included?
 
Do the charts of travel distance standards in COMAR 31.10.44.04 include the appropriate mix of providers?  Should any providers be added (e.g. child psychiatrist) or removed, and why?
 
Are the current mileage metrics for the travel distance standards in COMAR 31.10.44.04 appropriate?
 
Should carriers be required to comply with the travel distance standards for 100% of enrollees, or should the threshold be 95% to be consistent with the appointment waiting time standards, and why?
 
Should the regulations be revised to require that travel distance standards are based on “road travel distance”? Why or why not?
 
For enrollees covered under student health plans, should the regulations mandate or allow that the school’s address be used for determining travel distance standards?
 
For the essential community provider standard, COMAR 31.10.44.04C requires that a provider panel “shall include 30 percent of the available essential community providers in each of the urban, rural, and suburban areas.”
 
Should the regulation be revised to require a standardized methodology for calculating the 30% inclusion standard by geographic region?
 
Should carriers be required to provide a list of all contracted ECPs within their network for each provider panel?
 
Should the regulations require a standardized methodology to measure wait time standards, and if so, what methodology?
 
Are the current time period metrics for the waiting time standards in COMAR 31.10.44.05 appropriate based on the availability of healthcare providers in Maryland?
 
Please note that a deadline for the submission of written comments will be established at a later date.

2019 Hearing Testimony

 
  • View comments submitted by Maryland Society of Pathologists November 4, 2019.

2016-2017 Workgroup

 
  • ​2016-2017 Network Adequacy Regulations Page
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