We can make a change now!

Please send comments about this draft. 

It can pave the way for ensuring gender choice by patients for  ALL their providers in healthcare.

A friend alerted me to this:

The National Association of Insurance Commissioners has released draft regulations expected to impact the makeup of health plan provider networks on a state and federal level, including on the marketplace exchanges set up under the Affordable Care Act.

NAIC in November released draft updates to its Managed Care Network Adequacy Model Act, [link: http://www.naic.org/documents/committees_b_rftf_namr_sg_exposure_draft_proposed_revisions_mcpna_model_act.pdf] a model law routinely used by state and federal lawmakers when creating insurance laws and regulations, particularly in regards to the creation of health carrier networks and the adequacy and accessibility of services offered under a network plan.

The model Act, which hadn’t been updated since 1996, has been highly anticipated due to the changing insurance landscape under the implementation of the ACA. A controversy over the use of narrow networks on the marketplace exchanges has led the Centers for Medicare and Medicaid Services to investigate the adequacy of provider networks more closely; and the agency said it was waiting for NAIC’s revamped model law before proposing changes to its network adequacy policy for products offered on the 2016 exchanges...

These were my comments:

The reason that gender is a criteria, is because many people exercise their Constitutional rights under Title VII of the Civil Rights Act of 1964 and The Federal Nursing Home Reform Act (“OBRA 87”).

There is a reason that gender is included in directory listings. The problem is that once you get there, nurses, PAs, technicians, etc. who may be necessary for treatment are of the opposite gender of the physician.

There needs to be the additional criteria for the "gender of other personnel" AND "can accommodate request for same gender care."  

What caught my attention was that this paper is being discussed in "narrow networks." By adding the additional criteria of "requiring networks to be broad enough to accommodate request for same gender care," can further the original intent of including the gender criteria originally. 

My friend made the following recommendations:

Include 2 additional criteria for the following in section 8:

Section 8.B(1)(f) Gender of support staff;

Section 8.B(1)(g) Provide same gender care for;

Section 8.B(2)(d) Gender of support staff;

Section 8.B(2)(e) Provide same gender care for;

Section 8.B(3)(e) Gender of support staff;

Section 8.B(3)(f) Provide same gender care for;

Section 8.C(1)(f) Gender of support staff;

Section 8.C(1)(g) Provide same gender care for;

Section 8.C(2)(c) Gender of support staff;

Section 8.C(2)(d) Provide same gender care for;

Section 8.C(3)(e) Gender of support staff;

Section 8.C(3)(f) Provide same gender care for;

Here is an example of the new criteria:

Section 8.B(1)(f) Gender of support staff;

This can be answered: "All Female," "All Male," OR "Both Female and Male."

Section 8.B(1)(g) Provide same gender care for;This can be answered: "Female," "Male," OR "Both Female and Male." This is important due to the situation I mentioned above where the urologist is male, but the rest of the staff is female. The following is possible:

Section 8.B(1) For health care professionals:

(a) Name; Dr. So-and-so
(b) Gender; male

(c) Contact information; (555) 555-1212

(d) Specialty;  urology

(e) Whether accepting new patients. Y

(f)  Gender of support staff: Female

(g)  Provide same gender care for: Male

In this situation, the practice can bring in a male nurse from the affiliated hospital to provide for all male care with advanced notice. This is another trend in today's healthcare. 

I also included references to gender choice in healthcare and modesty issues. 

Here is where to direct comments:

Comments are being requested on this draft by Jan. 12, 2015. The revisions to this draft reflect changes made from the existing model. Comments should be sent only by email to Jolie Matthews at jmatthews@naic.org. 

I am encouraging everyone to comment on this. We can make a difference...