Networks at the Nexus: Revisiting New York State’s Provider Network Standards and Protections

Publication date: 
May, 2017
Source(s): 
United Hospital Fund

Networks at the Nexus: Revisiting New York State’s Provider Network Standards and Protections

Hundreds of thousands more New Yorkers have joined insurance plans since the Affordable Care Act went into effect, and health plans are increasingly trying to control costs by offering narrow networks of health care providers. Networks at the Nexus examines consumer protections and network adequacy standards in New York and recommends a series of steps the state could take to ensure transparency and access on this issue of critical importance to health insurance consumers.

Recommendations from the report include creating a central database that allows health plans and regulators to improve the accuracy of provider directories; updating standards on minimum waiting times for appointments; improving the appeals process for consumers who want to see out-of-network providers; enhancing disclosure about whether providers are accepting new patients; supplementing new “provider look-up” tools for consumers; regularly convening providers, consumers, health plans, and policymakers to address issues with New York’s standards; and more.

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