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Bill Would Require Insurers To Improve Provider Network Lists

State Sen. Ed Hernandez (D-West Covina) has introduced a bill (SB 137) that would require insurers to improve and frequently update their provider network directories, the Los Angeles Times reports.

Background

The bill was introduced in response to complaints of narrow networks among insurers selling plans through Covered California, the state's health insurance exchange (Terhune, Los Angeles Times, 1/23).

Several California insurers have been sued over inadequate networks. In addition, a Department of Managed Health Care report in November 2014 said that Anthem Blue Cross and Blue Shield of California violated state law by misleading consumers about the size of their provider networks (California Healthline, 11/19/14).

Details of SB 137

SB 137 would require insurers to:

  • Update their provider lists weekly and make that information available online for consumers;
  • Post online whether in-network physicians are accepting new patients; and
  • Publicize what languages their in-network providers speak.

It also would require state regulators to develop a standard format for provider directories.

The bill is sponsored by:

  • The California Pan-Ethnic Health Network;
  • Consumers Union; and
  • Health Access (Los Angeles Times, 1/23).

The Senate Health Committee will consider the bill in April.

In a release, Hernandez said, "In a world where we compel people to purchase health insurance, we must empower consumers to make accurate and informed decisions about the plans and policies they are choosing" (Hernandez release, 1/23).

Reaction

Anthony Wright, executive director of Health Access, said, "We don't allow other products to be sold with an inaccurate listing of ingredients," adding, "We can't have consumers spending significant dollars on premiums for plans with inaccurate listings of their providers."

However, Charles Bacchi, president of the California Association of Health Plans, said, "Health plans and providers have a shared responsibility in ensuring directories are updated in a timely manner," noting that the association will work with lawmakers on the bill (Los Angeles Times, 1/23).

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