Feb. 20, 2015
AADA rallies physicians for network adequacy reforms
The AADA is calling for changes that safeguard seniors’ access to specialty care for 2016 Medicare Advantage (MA) plans. Securing support from 30 provider groups, the AADA’s recent appeal to the Centers for Medicare and Medicaid Services (CMS) urges protections against unwarranted network terminations and inaccurate plan directories.
Mounting evidence shows that network directories inflate the number of available physicians and misleads seniors. Compounding a lack of transparency for plan networks, physicians throughout the country have been removed “without cause” from MA plan networks during the benefit year, which needlessly disrupts patients’ care. The AADA believes health plans must be barred from removing physicians from networks after seniors have already locked into their coverage. Such a measure would prevent disruption of care.
Meanwhile, the number of states acting to achieve exchange plan network adequacy continues to grow. Most recently, the AADA responded to a proposal by the Montana Commissioner of Securities and Insurance, underscoring the need for sufficient access to specialist and subspecialists and accurate plan directories.
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