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Key Consumer Protection Bills Would Improve Provider Directories, Eliminate Hidden Fees (UPDATE)

Key Consumer Protection Bills Would Improve Provider Directories, Eliminate Hidden Fees (UPDATE)

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.

Incorrect or out-of-date provider directories particularly impact communities of color, who often face an insufficient distribution of providers, transportation barriers, language barriers, and lack of flexible hours. Inadequate directories make it more challenging to find available providers, may delay timely access to care, or prevent a consumer from receiving culturally and linguistically appropriate care.

Provider directory errors are also particularly challenging for Limited English Proficient (LEP) and immigrant consumers, who tend to have lower health literacy and may need additional support in understanding the health care system. A culturally and linguistically appropriate provider is especially critical for these consumers, but they are less likely to be able to navigate around incorrect provider information and find the support needed to make an informed decision.

The article also discusses AB 533 (Bonta), which would cut down on surprise medical bills resulting from referrals to out-of-network specialists. Specifically, the bill would make it so patients visiting in-network hospitals do not receive additional charges for seeing out-of-network physicians unless they agree to the fee increase at least three days in advance. AB 533 is awaiting a vote on the Senate floor before it heads to Governor Jerry Brown’s desk.

These two bills are vital for protecting consumers and facilitating patient navigation through the health care system. There are too many opportunities for confusion, frustration, and hidden charges in the system today, and even more so for communities of color and LEP patients. By improving the accuracy of provider directories and eliminating hidden fees for out-of-network care, we can go a long way toward making sure that patients can more easily find doctors who meet their needs and are in their network.

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