The coronavirus pandemic of 2020 has created a seemingly paradoxical scenario for the finances of health care providers. While states were rushing to build field hospitals to prepare for a surge of COVID-19 patients, traditional revenue streams for providers completely dried up: elective procedures were suspended and social distancing protocols limited the number of patients in office settings. A public health crisis became a health care crisis, as COVID-19 revealed the faults in the way necessary and critical health care services are paid for in America.
Department of Insurance Tools for Plan Year 2015 Form Filings and Review Webinar
With the first open enrollment period having come to an end, states are immediately gearing back up to ensure that consumers again have strong plan options available on the Marketplace for 2015. Insurers will soon be filing forms and rates with state insurance departments, and regulators will be working through those filings to certify products to be offered on the Marketplace during the next open enrollment period. States also will be looking especially closely at issues like network adequacy, which have received much attention in the news in early 2014.
To that end, the State Network, through its team at the Georgetown University Health Policy Institute, has updated its form review checklists and created a number of new tools to help insurance regulators streamline the form review process. In this webinar, Sally McCarty and David Cusano of Georgetown University Health Policy Institute introduced department of insurance staff to these tools, discussed how to use them, and described some of the policy and operational considerations that regulators will want to consider during the form review process. Specifically, the webinar walked through the following resources:
- Network adequacy planning tool
- Individual market form review checklist
- Small group market form review checklist
- Catastrophic plan form review checklist
- Stand-alone dental form review checklist
- Qualified health plan issuer certification checklist
- Mental health parity and addition equity act issuer checklist and certification
- Issuer essential health benefits crosswalk and certification
The webinar slides can be found at the “download” button and a webinar recording can be found here.