California health plans win provider directory fight
A bill that could have created a listing accuracy mandate stalled in a state Senate committee.
California lawmakers have let a closely watched health plan provider directory accuracy bill die in committee.
The bill would have required health plans to meet a 95% accuracy standard by July 1, 2028. It also would have required state regulators to use provider directory network information standards that all state-regulated health insurers and health plans in the state would have had to use.
Failures to comply with directory standards could have led to fines of $500 to $5,000 per 1,000 enrollees affected.
Members of the state Assembly passed the bill by a 59-9 vote in January, and it passed by a 9-1 vote in the Senate Health Committee in June. But the Senate Appropriations Committee then voted 7-0 earlier this month to put the bill on hold.
Health Access California, a patient advocacy group, argued that the bill was necessary because inaccurate, stale directories make the impact of health care provider shortages worse, by hurting patients’ efforts to find providers who are willing and able to accept new patients.
Related: New York cracking down on insurers’ ‘ghost providers’ amid mental health crisis
Advocacy group complaints about network adequacy and network directory accuracy concerns have been common throughout the country in discussions about problems with mental health care.
America’s Health Insurance Plans worked with the Association of California Life & Health Insurance Companies, the California Association of Dental Plans, the California Association of Health Plans, the California Medical Association, the Los Angeles County Business Federation and other major payer and provider groups to oppose the bill.
Opponents argued that the bill was unclear and could have exposed plans to huge fines for harmless typos.
Health plans said the bill gave physicians and other providers too little responsibility for helping to keep their directory entries current.
Some provider groups said lawmakers and health plans should do more to reduce the time providers have to spend on maintaining their directory entries.