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Health Insurance Bulletin 2020-2

Office of the Health Insurance Commissioner

Identifies temporary variances from regulatory requirements to grant health insurers flexibility to hold providers harmless for aberrations in cost and quality performance due to COVID-19. These include variances from: hospital fee schedules tied to quality performance, value based contracts with Integrated Systems of Care, shared savings and risk contract provisions, quality performance requirements, shared savings and risk incentives, and annual alternative payment methodology targets. Health insurers are still required to report complaince data to OHIC, but may request a deadline extension. Health insurers are expected to make reasonable accomodations for prospective payment models for primary care services. Not waiving primary care spending requirement, will revisit in the Fall of 2020.

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