Challenges Facing “Narrow” Provider Networks on the ACA Health Care Insurance Exchanges

Overview


Health care insurers are trimming the number of contracted providers for their health care plans offered through the health benefit exchanges and the Medicare Advantage program. There have been attempts to constrain or facilitate the implementation of narrower provider networks through legislation, regulation and litigation. This article highlights the conflicts between the competing interests of insurers, providers and patients, as well as developments at the state and federal level to resolve these conflicts.