An Act relative to insurance companies and quality measures.
Proposes the process for the implementation of a physician performance evaluation program.
The commissioner shall promulgate by regulation uniform criteria for determining network adequacy for a tiered network plan based on the availability of sufficient network providers in the carrier’s overall network of providers, including standards for adequate geographic proximity of providers to members, taking into account distance, travel time and availability of public transportation. In determining network adequacy, the commissioner shall require that carriers classify providers into tiers so that every member enrolled in a plan has reasonable access to at least one provider in the lowest cost-sharing tier for every covered service.