This bill amends existing legislation to establish additional network adequacy standards for health insurance carriers that provide managed care plans. It requires the Commissioner of Banking and Insurance to adopt regulations that ensure covered individuals have reasonable and timely access to physician specialists at in-network hospitals and facilities. The bill specifically mentions the inclusion of anesthesiologists, radiologists, pathologists, and emergency medicine physicians among the specialists whose access must be guaranteed.

The bill also updates the legal language to clarify that the regulations will govern various aspects of managed care plans, including quality management programs, provider participation, and consumer rights. It emphasizes the need for a comprehensive approach to network adequacy, ensuring that the provider network is sufficient in scope and geographic coverage to meet the healthcare needs of covered persons. The act is set to take effect immediately upon passage.

Statutes affected:
Introduced: 26:2S-18