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Confused by the ACA’s “Narrow Networks?” Physicians Are Too.

The use of so-called narrow networks in health plans sold through the Affordable Care Act marketplaces has proved to be a controversial way of reducing premiums, especially since many of the new consumers were unaware they would have to pay more for medical services if they went “out of network,” or the services wouldn’t be covered at all. It turns out many physicians have been just as confused as consumers.

In a session on ACA networks at the Nov. 7 annual conference of the National Committee for Quality Assurance, which accredits health plans, Blue Shield of California Vice President Marcus Thygeson said there “was a tremendous amount of provision confusion” among doctors about whether they were in the company’s network plans offered on Covered California, the state-run ACA marketplace.