New Law Will Require State to Keep Provider Directories Updated

October 15, 2015

 

By Hannah Guzik

Responding to reports that provider directories often contain numerous errors, Gov. Jerry Brown has signed a bill that will require insurers to update their lists of doctors weekly.

The bill, SB 137, will help people who are shopping for health plans as well as those who already have insurance but need to find a doctor.

A California Health Report investigation in June 2014 found that provider directories for people in the state’s low-income health plan were highly inaccurate. More than half of the primary-care doctors listed in directories given to Medi-Cal patients in three counties in Northern, Central and Southern California were not accepting new patients or could not be reached by telephone, reporters found.

This June, the California State Auditor also found that the provider directories for Medi-Cal were peppered with errors that the Department of Health Care Services didn’t catch.

The new law will take effect Jan. 1, and insurers could be required to comply with the new regulations by Sept. 15, according to the California Pan-Ethnic Health Network, which co-sponsored the bill.

Insurers will be required to provide consumers with provider directories when they are shopping for plans and when they are enrolled. The lists must be updated weekly and provide accurate information on office locations and whether providers are accepting new patients.

The new law will especially help Californians who speak limited English, according to the Pan-Ethnic Health Network.

“The new law will make it easier for consumers shopping for health coverage to find a doctor who speaks their language or ensure their current bilingual provider is in their plan,” Sarah de Guia, the nonprofit’s executive director, said in a release. “The law also strengthens consumer protections by requiring health plans to include a notice in the directory informing consumers about language assistance services.”

It should also help people avoid out-of-network charges, according to Betsy Imholz, Special Projects Director for Consumers Union, an advocacy branch of the nonprofit Consumer Reports, which also co-sponsored the bill.

“California consumers need to know which doctors and hospitals are in plan networks when they are choosing and using their health coverage, to keep care affordable and avoid surprise out-of-network charges,” she said in a release. “By setting uniform standards for directory elements, with frequent updates, this bill lays the groundwork for creating a consolidated statewide directory across plans for truly informed consumer choice.”

Advocates hope the new law will help shift insurers to become more responsive to consumer demand, said Anthony Wright, executive director, Health Access California, a consumer advocacy coalition that was the final co-sponsor of the bill.

“Just as we don’t allow grocery stores to sell food mislabeled with the wrong ingredient,s we shouldn’t allow insurers to sell health plans without accurate provider directories,” he said in a release. “Now with more up-to-date directories, health care consumers will have an easier time making decisions about what plan they are buying, or which provider to go to.”

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