Some states may urge insurers to widen provider networks as they prepare for the next open enrollment period for health insurance exchanges.
California, for example, already is asking insurers to add more doctors to their networks before the next open enrollment. That largely stemmed from hundreds of consumer complaints to the state insurance agency about being forced to find a new physician, including some pregnant women who had to see a new obstetrician for their birth, reported KQED.
"We're doing very active monitoring and in particular in coordination with the Department of Managed Health Care to investigate and assure that plans' networks are adequate," Covered California Executive Director Peter Lee said at the exchange's board of directors meeting.
But the statewide insurance group warns that neither the exchange nor the state should force too many network requirements on insurers. "Tailored networks maintain affordability," Athena Chapman, director of regulatory affairs for the California Association of Health Plans, told KQED.
Meanwhile, Anthem Blue Cross in California has added almost 4,000 providers, including major hospitals like UC Davis Medical Center and Cedars Sinai Medical Center, to its network since January, the Sacramento Business Journal reported.
Although the move came after insurers were spotlighted for restricting exchange enrollees' access to doctors, Anthem spokesman Darrel Ng said the recent network expansion wasn't in response to any complaints.
"Much of the time, it's doctors who are calling us and want to join our network," Ng told the Journal. "They see the volume on the exchange, hear about their former patients who they won't be seeing anymore and decided to contract with us."
To learn more:
- read the KQED article
- see the Sacramento Business Journal article