Review every carrier, not just the ones you can afford to.
Network adequacy verification for state regulators.
The NBPP devolves ACA network adequacy authority to states, and most state DOIs don't have budget for legacy six-figure licenses per carrier review. Radius is an API-driven, CMS-methodology platform priced for continuous use: run verification across every filing in your market, on the same engine carriers will see at CMS ACC.
Current tools weren't built for this many reviews.
The existing adequacy vendors were architected for a single regulator (CMS) running batch review of a manageable number of carrier filings. State DOIs face a different problem: dozens of carriers, multiple filings per year, lean staff, and procurement budgets that won't stretch to parallel enterprise licenses. You need an API, not a quarterly spreadsheet, and a price point that covers your full market, not just the top five carriers.
A quarterly spreadsheet per workflow.
Enterprise annual licenses. Overnight batch runs. Output formatted for printing, not integration. Built for one reviewer (CMS) evaluating submissions, not a state running continuous review across every carrier in its market.
A fast, scriptable, affordable API.
Continuous re-computation as carrier filings arrive. Comparative dashboards across every issuer in the state. Pricing that lets one analyst do the work of ten, and covers the full market, not a rationed subset.
Four tools for an Effective Review Program.
The same CMS-methodology engine that powers every Radius view, exposed as an API designed for regulator workflows. Every computation is reproducible, every input sourced to public data, every finding defensible under administrative challenge.
Re-run T&D on every submission.
We re-execute the carrier's adequacy claim against NPPES, TIGER, and best-in-class drive-time routing, on the same CMS methodology, independently of their tooling. Discrepancies surface with the exact county, specialty, and provider IDs responsible.
Catch the phantom-network playbook.
Providers appearing across competing carriers' networks with claim-activity profiles that can't be real. Specialty taxonomies inflated for HSD purposes. Retired providers still counted. Systematic gaming surfaced, not one ghost at a time.
Every carrier, side by side.
County-level adequacy scores across every carrier in your state, on one dashboard. Enforce consistently. Spot the outlier. Publish the comparison. The only accountability mechanism that scales to a full-state review.
Findings your constituents can actually read.
Consumer-facing adequacy scorecards for marketplace integration, legislative briefings, and press releases. The accessibility measure that turns a technical review into a policy lever.
Fast, affordable, independent, pick all three.
The existing adequacy vendors each come with compromises, while none were built for state-scale review programs.
Radius is API-first, priced for continuous use across every carrier in your market, and has no business relationship with the entities you regulate. Run the verification on the same CMS methodology, with the code and data lineage available for public audit. Built to cover the full market, not ration it.
Same methodology as CMS ACC, exposed as a modern API.
Every computation is auditable, every dataset public, every step of the methodology published. The carrier's submission becomes one input among many.
Carrier filings, ingested.
HSD tables, provider directory snapshots, and submission artifacts, loaded at filing cadence. Every input preserved for the audit record.
Ground-truth cross-checked.
NPPES, TIGER, state medical boards, Medicare Fee Schedule. Independent of carrier assertions about specialty, status, or location.
T&D re-computed.
Best-in-class drive-time routing scored via a purpose-built geospatial engine against CMS county-tier standards. Results reproducible on demand.
Findings, defensible.
Discrepancy reports, exception dashboards, and public scorecards, each traceable to raw inputs, written to survive administrative challenge.
Built for the offices standing up Effective Review.
Insurance commissioners. State-Based Marketplace operations. Medicaid MCO oversight teams. The ~20 states likely to build dedicated ERP infrastructure before 2027, and the offices already doing it with spreadsheets.
State Departments of Insurance
Regulatory authority over commercial and ACA plan filings. Procuring ERP infrastructure under the NBPP timeline, alongside the next wave of states committing to quantitative review.
State-Based Marketplaces
WA Healthplanfinder, Covered California, NY State of Health, and the ~18 SBM states operating their own ACA exchanges. Quantitative T&D enforcement came online January 2026. The review infrastructure needs to follow.
Medicaid agencies
State Medicaid authorities overseeing MCO network adequacy. High-stakes population, existing federal audit exposure, and the least tolerance for a conflicted vendor on the review side.
The review obligation is landing, with or without the infrastructure.
Three timelines are converging inside an 18-month window. States that procure early define the vendor landscape. States that wait inherit it.
NBPP devolution
Federal ACA network adequacy authority devolves to states. Each state must establish and operate an Effective Review Program. Most state DOIs do not yet have the staffing, tooling, or methodology to execute it independently.
Quantitative T&D live in SBMs
Washington Healthplanfinder and Oregon marketplace moved to quantitative T&D standards in January 2026. The next wave of SBM states is finalizing 2027 implementation. Review tooling is the missing layer.
Ghost-network precedent
OIG findings, Cigna's $5.7M federal settlement, and class action litigation are establishing the legal framework state DOIs will inherit. The case law on what a "reasonable" review program looks like is being written right now.
Stand up Effective Review before the deadline lands.
We're offering a structured briefing for state DOI, SBM, and Medicaid agency staff: a walk-through of the independent-verification methodology, a sample re-computation against a carrier in your state, and a procurement-ready reference architecture.