White House Addresses Concerns over Narrow Network Plans

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On March 14, the Obama administration addressed consumer concerns over narrow network plans being sold on the public exchange that exclude popular health facilities and practitioners. These narrow network plans that limit consumer choice kept premiums lower, but consumers reported difficulty in determining whether their doctor was in network before purchasing the plan.

The federal government plans to scrutinize these plans more carefully before open enrollment in 2015 with new standards to evaluate access in these narrow plans.  The standards require the plan to offer at least 30% of the essential community providers in a service area.  Those essential community providers include community health centers, family planning clinics, children’s hospitals, and treatment centers for those with HIV and AIDS.  Doctors considered in network on the plan must state whether or not they are accepting new patients, and the government will analyze co-payments for prescriptions drugs, hospitals stays, and specialist visits.