Summary as Introduced
Amends the Network Adequacy and Transparency Act. Provides that the Department of Insurance shall determine whether the network plan at each in-network hospital and facility has a sufficient number of hospital-based medical specialists to ensure that covered persons have reasonable and timely access to such in-network physicians and the services they direct or supervise. Defines "hospital-based medical specialists".
Staff Analysis
Amends the Network Adequacy and Transparency Act. Provides that, beginning January 1, 2026, every insurer shall demonstrate to the Director of Insurance that each in-network hospital has at least one radiologist, pathologist, anesthesiologist, and emergency room physician as a preferred provider in a network plan. Provides that the Department of Insurance may, by rule, require additional types of hospital-based medical specialists to be included as preferred providers in each in-network hospital in a network plan.