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Under draft 2023 exchange rule . . .

Feds To Resume Network Adequacy Reviews, Weigh Unintended Effects

By Amy Lotven / January 6, 2022 at 4:00 PM
HHS is proposing to resume network adequacy reviews starting in 2023 for qualified health plans (QHP) sold in states that rely solely on the federal exchange, and seeks to apply standards for time and distance, appointment wait times and tiered networks. In the draft Notice of Benefit Payments and Parameters out Dec. 27, the agency also acknowledges that strong adequacy standards could give providers a leg up in contract negotiations and seeks comments on potential ways to counter that potential,...


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