With the launch of the Affordable Care Act’s second open enrollment period this week, millions of people are again expected to flood marketplace websites to enroll or reenroll in health plans. At the same time, insurance commissioners are announcing draft regulations to help their states respond to an issue that was the subject of major controversy during the first round of enrollment: Some of the new health plans are offering consumers networks that exclude certain doctors, hospitals and other medical providers. Some claim that these networks hamper provider access and choice; others contend that this approach, if done the right way, helps consumers by creating competition and controlling costs, without compromising the quality of care.
The November 19 webinar will explain new draft regulations from the National Association of Insurance Commissioners. What are states already doing and must they adopt these regulations? How would this regulatory approach affect consumer costs and access to medical providers? How does it handle tiered networks? What is the effect on consumers, providers and health plans? Will there also be federal standards for health plan networks?
J.P. Wieske, legislative liaison and public information officer for Wisconsin Insurance Commissioner Ted Nickel, who chairs the NAIC’s regulatory framework task force, will explain the draft model regulations for states.William Gerardi
, chief medical officer and senior vice president of health management at Blue Cross and Blue Shield of Minnesota, will address the effect of the draft regulations on health plans.
John J. Reilly, Jr., senior medical director of population health, UPMC Health Services Division; and Jack D. Myers Professor and Chair, University of Pittsburgh Department of Medicine, will discuss the impact on medical providers, and on integrated health systems.
Marilyn Werber Serafini of the Alliance will moderate the discussion.
Follow the event on Twitter: #NetworkAdequacy
The event is sponsored by the nonpartisan Alliance for Health Reform, the BlueCross BlueShield Association and the University of Pittsburgh Medical Center
JP Wieske Presentation (Adobe Acrobat PDF)
William Gerardi Presentation (Adobe Acrobat PDF)
John J. Reilly Presentation (Adobe Acrobat PDF)
Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)