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December 04, 2013 at 12:34 PM
Having a serious conversation about public exchange plan provider networks is difficult, because many of the plans are still creating their networks.
Dr. Robert Gottlieb, a physician affiliated with the American Enterprise Institute, made that argument during a House Ways and Means health subcommittee hearing on the Patient Protection and Affordable Care Act.
Gottlieb testified he and colleagues tried to verify rumors that typical exchange plans will have narrow provider networks in 2014 by reviewing exchange plan provider network information.
For the most part, Gottlieb said, “this information isn’t available. We looked hard for it.”
PPACA includes a vaguely worded provision requiring exchange plans to have enough doctors and hospitals in their networks, and some states with state-based exchanges haven’t gotten their provider directory databases working.
In some cases, the plans still seem to be putting their networks together, Gottlieb said.
When Gottlieb’s team looked at the directories they could locate, they found that one plan in New York City listed no gynecologists.
In San Bernardino, Calif., one plan directory showed that the nearest in-network urologist would be 80 miles away.
