Legislation
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Effective Date
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1332 Waiver
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Funding Source
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Program run by or to be run by (gov, insurers, others?)
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Markets
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Carrier participation - voluntary or mandatory?
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Provider Participation
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Provider reimbursement
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Are there regional exclusions on provider payments?
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Plans first available in 2026.
OCTOBER 2023 EDIT: THE PUBLIC OPTION PROGRAM IS BEING TRANSFORMED INTO A MARKET STABILIZATION PROGRAM. PUBLIC OPTION PLANS WILL NO LONGER BE AVAILABLE IN 2026. SEE NABIP PUBLICATIONS FOR MOST RECENT NEWS.
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Not yet submitted
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Establishment of the Public Option Trust Fund, funding appropriated by state legislature. Additional federal funding through 1115 and 1332 waivers.
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Government (Medicaid)
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Individual |
Mandatory for Medicaid MCOs, but voluntary for other carriers. Medicaid MCOs must submit “good faith” bids to administer public option plans. Other carriers may submit bids as well.
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Mandatory participation for some providers.
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Provider rates in aggregate must be comparable to or better than Medicare rates, inclusive of add-on payments or subsidies; alternative approaches set for certain providers
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The reimbursement rates for a federally qualified health center or a rural health clinic under the Nevada Public Option must be comparable to or better than the reimbursement rates established for patient encounters under the applicable Prospective Payment System established for Medicare
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