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Provider Directories

Blog Posts tagged "Provider Directories"

Today, Governor Jerry Brown signed SB 137, a bill by Senator Ed Hernandez, to ensure accurate, updated, and standardized provider directories. Co-sponsored by California Pan-Ethnic Health Network (CPEHN), Consumers Union, and Health Access California, SB 137 will:

  • Make updated provider directories available to consumers both when they are shopping for plans and when they are using their benefits.
  • Update provider directories weekly—better than the federal standard of at least monthly.
  • Providing accurate information on important specifics such as office location and whether the provider is accepting new patients.
  • Allow consumers from diverse backgrounds to identify health plans and providers that can best meet their needs by indicating what languages other than English (if any) providers and their staff speak (for more details and rationale, see separate SB 137 fact sheet).

The measure had strong support from a range of consumer and community groups, with new urgency given the additional Californians in coverage under the Affordable Care Act — some with new ability to shop but needing accurate provider to make informed plan selections; others newly insured but who live paycheck to paycheck and can’t afford inadvertent out-of-network costs.

Update 3:30 pm: SB 137 (Hernandez) passed the Assembly Floor today.

Earlier: This morning, The Los Angeles Times printed an editorial in support of two bills that will improve consumer protection in the health care industry. The first, SB 137 (Hernandez), a bill co-sponsored by CPEHN, Health Access, and Consumers Union, will institute much-needed improvements to provider directories. The measure, which has passed the Senate and is currently awaiting a vote on the Assembly floor, would require regular updates to provider directories so that they are accurate and people know what doctors and hospitals are in their network when they shop for coverage or when they seek care.

The Times article detailed the need for SB 137:

But here and in other states, insurers have been competing by assembling "narrow" networks of healthcare providers, dropping more costly doctors and hospitals in favor of those that deliver high-quality care more efficiently. Unfortunately, the lists of in-network doctors and hospitals that insurers have posted have been riddled with inaccuracies, making it impossible to be sure which doctors you'll have access to when you sign up for coverage.

People shouldn't have to guess which doctors' services are covered by their policies, where they're located or whether they accept new patients.

The California Assembly Health Committee took another important step to increasing access to health coverage to all children in the state regardless of immigration status by passing Senator Ricardo Lara’s SB 4. The bill passed along party lines, with Democratic members in support and Republicans in opposition. The committee also passed one of CPEHN’s co-sponsored bills, SB 137 (Hernandez), which would enhance consumer protections by improving health plan’s provider directories. This important bill received bipartisan support.

The hearing began with Senator Lara explaining the benefits of his bill, which would expand access to full-scope Medi-Cal to all children regardless of immigration status and allow California to apply for a waiver through section 1332 of the Affordable Care Act allowing undocumented adults to purchase coverage through Covered California. He talked about the tremendous community support he’s received while working on Health for All legislation over the last two years.

Your support is needed to ensure consumers are informed about their health insurance benefits and know which doctors and hospitals are in their networks. Urge the California Assembly Committee on Health to pass legislation requiring translation of a health plan's summary of benefits and coverage (SBC) and ensuring provider directories are accurate and up-to-date. Please send in your letter of support today for SB 388 (Mitchell) and SB 137 (Hernandez)
 
SB 388 (Mitchell) requires a health insurance plan’s SBC to be translated into non-English languages consistent with California’s existing language access requirements for other vital documents and would require the California Department of Managed Health Care and the California Department of Insurance to make available translated templates of the SBC on their websites. Download a sample letter of support for SB 388. Letters must be received by 12:00 PM on Wednesday, June 24th.

SB 137 (Hernandez) creates standards for provider directories and requires regular updates so that they include accurate information about which doctors and hospitals are in a patient's network and the languages spoken when shopping for coverage or seeking care. CPEHN is co-sponsoring this legislation with Consumers Union and Health Access. Download a sample letter of support for SB 137. Letters must be received by 12:00 PM on Wednesday, July 1st.

Hearings for the bills are scheduled for: