Statement of the College of American Pathologists Re: National Association of Insurance Commissioners Adoption of Revisions to Network Adequacy Model Act

Nov 24, 2015, 13:18 ET from College of American Pathologists

WASHINGTON, Nov. 24, 2015 /PRNewswire-USNewswire/ -- The College of American Pathologists (CAP) is a national medical specialty society representing 18,000 physicians who practice clinical and anatomic pathology in community hospitals, independent clinical laboratories, academic medical centers, and federal and state health facilities. CAP President Richard C. Friedberg, MD, PhD, FCAP issued the following statement regarding the recent National Association of Insurance Commissioners (NAIC) approval of revisions to the national model bill on Health Plan Network Adequacy:

The CAP is disappointed that the NAIC rejected a key provision to include specific requirements for state regulators to evaluate the network adequacy of health plans for hospital-based physician services into the network adequacy model legislation. The CAP, as part of a coalition of hospital-based physicians, including radiologists, emergency room physicians, anesthesiologists, and hospitalists, believes that the NAIC's rejection of this requirement, as proposed by this coalition, demonstrates a failure by state regulators to effectively ensure that health plans approved by the state contain sufficient numbers of hospital-based providers so that patients at in-network hospitals and facilities have reasonable access to in-network physicians at these facilities. The final model bill, by rejecting this requirement and by including improper limitations on billing by out-of-network providers, is encouraging insurers to shrink and narrow their networks in ways that adversely affect the delivery of health care.

Charles Fiegl
(202) 354-7134

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SOURCE College of American Pathologists