AHA commends proposed updates to NAIC's model network adequacy legislation

Proposed changes to the National Association of Insurance Commissioners’ 1996 model state legislation for health plan network adequacy would help address problems that consumers and health care providers face with respect to the adequacy and transparency of health plan provider networks, AHA told a NAIC subgroup yesterday. “Of particular importance to our hospital members is the Subgroup’s work on ‘surprise bills’ to protect consumers from unexpected large bills and balanced billing,” wrote Ashley Thompson, AHA acting senior executive for policy. “…The AHA supports the proposed revisions, which would create a balanced solution amongst providers, health plans and hospitals to better protect the consumer from unexpected bills.” AHA also commended a number of other changes to the Model Act and urged additional changes, such as requiring that state insurance commissioners set quantitative standards for measuring network sufficiency and have prior approval authority of network access plans.