Covered Calif. Removes Provider Directory To Fix Inaccuracies

Last week, Covered California removed a consolidated directory of doctors and hospitals from the exchange website because some providers were falsely listed as accepting insurance plans that were not a part of their network, AP/Modern Healthcare reports (AP/Modern Healthcare, 2/9).

Background

The directory of health care providers associated with exchange plans originally was scheduled to be available during the first week of open enrollment -- which began Oct. 1, 2013 -- but it was delayed and did not go online until a week later.

The physician directory then was taken offline later that month because of:

• Inaccuracies; and
• Slow loading times.

In addition, some consumers had reported problems identifying which plans would be serviced by popular provider groups (California Healthline, 10/11/13).

Covered California published an updated directory in November 2013.

Details of Latest Removal

Some consumers who purchased coverage that took effect Jan. 1 said that certain physicians would not accept their insurance even though they were listed as part of their network on the exchange website, according to the Los Angeles Times' "Money & Co." (Terhune, "Money & Co.," Los Angeles Times, 2/7).

In a statement, Covered California spokesperson Anne Gonzales said, "While many people were having success with it, some were not," adding, "We decided that all of the plans needed to submit accurate data to us in order for it to work correctly" (Sisson, U-T San Diego, 2/7).

State officials noted that consumers still can switch plans before the first wave of open enrollment ends on March 31.

In the meantime, the exchange website will provide consumers with links to each health insurance plan's physician directory (Robertson, Sacramento Business Journal, 2/7).

Exchange officials said they do not have a "firm date" for reinstating the physician directory.

Reaction

In a statement, the California Medical Association said, "The state's exchange has done the right thing in trying to address the inadequacies and misinformation and, to that end, CMA will be as helpful as possible, but it is up to Covered California to get the provider directories promptly in order so that Californians can evaluate what kind of access each exchange plan offers" (O'Neill, "KPCC News," KPCC, 2/7).

Anthony Wright, executive director of Health Access California, said, "[I]t's especially important now that people have the ability to change plans ... to know what other plans their doctors are in." He added, "This is something we need to get a handle on quickly" (Sacramento Business Journal, 2/7).