Network adequacy

Network adequacy in healthcare in the United States is having sufficient providers within a health plan network to ensure reasonable and timely access to care. [1]

Health insurance plans may include ghost providers to falsely maintain compliance.[2] There are no federal standards, though several states, including California, have passed legislation to ensure minimum network adequacy.[3]

References

  1. ^ Bradley, Katharine; Wishon, Allison; Donnelly, Alexandra; Lechner, Amanda (November 2021). "Network Adequacy for Behavioral Health: Existing Standards and Considerations for Designing Standards". U.S. Department of Health and Human Services. HHSP233201500035I. Retrieved 22 September 2024.Public Domain This article incorporates text from this source, which is in the public domain.
  2. ^ Rahim, Hannah (December 6, 2023). "Addressing Ghost Networks in Mental Health Care". Bill of Health. Petrie-Flom Center. Harvard Law School. Retrieved 22 September 2024.
  3. ^ Pollitz, Karen (4 February 2022). "Network Adequacy Standards and Enforcement". KFF. Retrieved 22 September 2024.
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