August 17, 2022

State Roundup — Network Adequacy Proposed Rulemaking

In July, the Maryland Insurance Administration issued a revised version of their proposed Network Adequacy regulation and asked for public comments.

This revised version of the rule deleted the entire section of the original 2020–2021 proposal that assessed health plans for network adequacy for hospital-based physicians as a prerequisite for approval by the administration.

The issue of network adequacy remains a great concern to hospital-based physician specialties that had previously commented in support of the requirement.

The American College of Radiology® (ACR®) and the Maryland Radiological Society joined a stakeholder coalition led by MedChi, the Maryland State Medical Society, in drafting a letter to the administration urging them to add this specific language to the draft rule:

“A carrier shall develop and maintain a network in sufficient numbers, geographic locations, and practicing specialties, INCLUDING TIMELY ON-SITE ACCESS TO EMERGENCY SERVICES, ON-CALL PHYSICIANS AND HOSPITAL-BASED PHYSICIANS, to ensure enrollees have access to participating providers for the full scope of benefits and services covered under the carrier's health benefit plan.”

For more information on this, or any other state related matter, please contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior State Government Relations Specialist.