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Governor Brown Signs Legislation Requiring Updated, Standardized Health Plan Provider Directories

For Immediate Release
Thursday, October 8, 2015

Governor Brown Signs Legislation Requiring Updated, Standardized Health Plan Provider Directories

SACRAMENTO – 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.

 “Today, California took an important step toward improving access to quality health care for all consumers, especially those with limited English proficiency,” said Sarah de Guia, Executive Director of the CPEHN. “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. The law also strengthens consumer protections by requiring health plans to include a notice in the directory informing consumers about language assistance services. SB 137 is a critical tool for all Californians and will help improve access to care,” adds de Guia.

”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,“ noted Betsy Imholz, Special Projects Director for Consumers Union, the Advocacy and Policy arm of nonprofit Consumer Reports. “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.”

“Just as we don't allow grocery stores to sell food mislabeled with the wrong ingredients we shouldn't allow insurers to sell health plans without accurate provider directories. 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," stated Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition. “Our hope is that over time this will make the marketplaces more responsive to consumer demand for accessible, high quality care.” 

The bill was also spurred by concerns about provider networks and access to care in Medi-Cal managed care plans or in “narrow networks” in Covered California or employer-based coverage plans. The public’s concerns were reaffirmed last year when surveys of two prominent California health plans by the Department of Managed Health Care found that 25% of their provider directories were inaccurate.

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About California Pan-Ethnic Health Network

The California Pan-Ethnic Health Network (CPEHN) is a multicultural health advocacy organization working to improve the health of communities of color in California. Our mission is to promote health equity by advocating for public policies and sufficient resources to address the health needs of communities of color.

About Consumers Union

Consumers Union is the policy and advocacy division of Consumer Reports. Consumers Union is an expert, independent, nonprofit testing, information and advocacy organization serving only consumers. Consumers Union’s publications — with approximately 8.3 million combined paid circulation — carry no advertising and receive no commercial support. Consumers Union’s income is derived from the sale of Consumer Reports and ConsumerReports.org, our other publications and from noncommercial contributions, grants and fees.  The West Coast Office, located in San Francisco, was founded in 1975.

About Health Access

Health Access works to secure quality, affordable health care for all Californians. Health Access California is the statewide health care consumer advocacy coalition, advocating for the goal of quality, affordable health care for all Californians. Health Access Foundation undertakes community organizing and education, applied research, and policy analysis, and advocates for reform to benefit health care consumers, both insured and uninsured. These two organizations are the leading coalition voice for health care consumers in California. We represent consumers in the legislature, at administrative and regulatory agencies, in the media, and at public forums.