Life & Health Network Adequacy Working Group (NAWG) About the Network Adequacy Working Group The Network Adequacy Working Group (NAWG) is comprised of department of insurance staff, consumer advocates, provider organizations and the insurance industry. The purpose of NAWG is to allow key stakeholders the opportunity to provide input on the National Association of Insurance Commissioners (NAIC), 2015 Health Benefit Plan Network Access and Adequacy Model Act (“the Model Act”). “The Model Act” provides guidelines for state insurance regulators and the insurance industry to follow to ensure adequate networks for health insurance in states. There is an opportunity for the development of standards specific to North Carolina. The NAWG will review “the Model Act”, discuss possible additions or modifications, and provide input to Commissioner Goodwin on the recommended final proposal for network adequacy and accessibility standards to be considered for adoption. It is anticipated the NAWG will meet up to three times with a limited number of conference calls and will complete work by the fall of 2016. The North Carolina Department of Insurance welcomes comments from the public relating to the adoption of specific network adequacy standards and related provisions as provided in the NAIC Health Benefit Plan Network Access and Adequacy Model Act. The Department will consider input from the NAWG, as well as the public, as it decides how to address adoption of the Model Act in NC. NOTE: The Department will read all comments, however we may not respond to all comments. In order for us to respond to your comment, you must provide an email address in the form below. All information submitted to the NC Department of Insurance is subject to open records laws. Please provide the requested information to the best of your ability in order that the Department may identify the company and filing to which your comments apply. Provide Public Comment On Network Adequacy Standards for NC *Required Field First* Last* Organization Mailing Address City State* NC AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI Zip Email Comment* Staff Recommendations Staff Recommendations for Proposed Amendments to NC’s Network Adequacy and Accessibility Standards – 12/22/16 Network Adequacy Working Group Final Recommendations from Stakeholder Representatives Final Recommendations from Consumer Advocates Reps Final Recommendations from Provider Reps Final Recommendations from Industry Reps Background Materials NAIC Model #74 – Health Benefit Plan Network Access and Adequacy Model Act Listing of Current NC Laws and Regulations relating to Network Adequacy and Access Comparison of NC Regulations and Statutes to Health Benefit Plan Network Access and Adequacy Model Act Resource Materials for Meetings Surprise Billing Text of Florida House Bill 221 Surprise Billing – Summary of Florida House Bill 221 Examples of Network Accessibility Standards – Other Jurisdictions Washington State Health Benefit Plan Management - Chapter 284-170 WAC Federal Exchange Standards for QHP Certification – 2017 Letter to Issuers in the Federally-Facilitated Marketplace Medicare Advantage – Network Criteria Guidance for Calendar Year 2017 Medicare Advantage – Health Service Delivery Tables – Specific Criteria by County Families USA – Report on Standards for Health Insurance Provider Networks from the States Network Accessibility - Summaries Summary of Medicaid Managed Care Final Regulations – Network Adequacy & Access – National Health Law Program Issue Brief No. 3 Center on Health Insurance Reforms – Issue Brief for The Commonwealth Fund – Implementing the Affordable Care Act: State Regulation of Marketplace Plan Provider Networks Meeting Materials Kick Off Meetings N.C. Department of Insurance 430 N. Salisbury Street Raleigh, NC Room 2009 6/1/2016 (Wed) at 2pm - Network Adequacy Discussion Group - Consumer Reps Summary of June 1 Meeting List of Attendees 6/7/2016 (Tue) at 2pm - Network Adequacy Discussion Group - Industry Reps Summary of June 7 List of Attendees 6/8/2016 (Wed) at 2pm - Network Adequacy Discussion Group - Provider Reps Summary of June 8 List of Attendees