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MonthlyByte     Jan. 2020   As the representative and recognized voice of the dental benefits industry, NADP advanced your positions among key stakeholders. Meetings X12 Dental Informatics Manager Brian…

In 2014, the National Academy for State Health Policy (NASHP) convened a group of oral health experts and produced a White Paper on dental experience in the Exchanges/Marketplaces.

In early March, the California Department of Managed Health Care (DMHC) distributed a notice instructing carriers that maintain provider lists to submit a Provider Directories filing no later than April 30, 2015. According to the checklist, this filing is required of full service plans and specialized plans that maintain a provider list pursuant to Section 1367.26.

NADP submitted comments this month to the Ohio Department of Insurance (ODI) responding to draft rules on provider network disclosures. The letter recommends the ODI specifically exclude standalone dental plans from application and addresses areas where dental and medical networks differ, as well as identifies draft provisions that would increase administrative costs and thus premiums without added benefits to the consumer.

A subgroup of the National Association of Insurance Commissioners (NAIC) has been hosting twice weekly calls as they update the NAIC Network Adequacy Model to reflect with the ACA provisions and increased scrutiny of networks by the states. The subgroup consists of a variety of stakeholders, including regulators, carriers and consumers. This Model is critical to the insurance industry as it will become the new basis of network regulations for the states, as well as for carriers operating on the Federally Facilitated Marketplace (FFM).

To follow-up on a meeting held in September on this topic, NADP along with the Life Insurance Council of New York (LICONY) responded this week with industry views and recommendations on New York network adequacy standards. Recommendations include that agencies consider carriers attempts to recruit providers in shortage areas and allow for an exemption or alternative network adequacy requirements in upstate counties that lack “recruitable” providers. An additional meeting or conference call may be held after the agencies review and respond to industry recommendations.

MonthlyByte     December 2015   STI 2015 Highlights To enhance representation of the dental benefits industry, the NADP Board of Directors approved creation of the Standards and Transaction Initiative…

The Government Relations Workgroup (GRW) and its subgroup on Network Adequacy monitor legislative and regulatory proposals impacting the dental benefits industry.

NADP was contacted by the Congressional Budget Office (CBO) this month and met via conference call to discuss the equitable treatment bill, H.R. 3463.