Objective To understand how Medicare Advantage (MA) networks impact utilization patterns and plan choices, using the 2019 discontinuation of MA 1876 Cost plans as a natural experiment. Study Setti...

9.7.23 Subscribe How difficult is it for people with marketplace insurance to find in-network health care providers, and how do delays and challenges in accessing care affect people’s lives? This…

Staff explained SSB 5124 would require the Health Care Authority to adopt network adequacy standards for nursing homes and inpatient rehab facilities with compliance deadlines in 2028; hospital and health-system witnesses supported the measure, citing costly single-case agreements and delayed discharges.

The committee adopted a committee substitute for SB 121 changing the proposed minimum insurer reimbursement to 345% of Medicare's fee schedule, includes network adequacy and audits, and set the bill aside for further consideration with an effective date of Jan. 1, 2027.

The state imposed a $250,000 penalty on MVP Health and asked it to provide restitution for enrollees hurt by inaccurate directory entries.

Johnson highlights provider availability and efforts to combat fraud in behavioral health.