Health plans and health insurance companies will need to come up with an accurate directory of providers under a bill that passed a Senate floor vote on Wednesday in the California Legislature.
“The problem started occurring when Covered California first set these [provider directories] up” last year, said bill author Sen. Ed Hernandez (D-West Covina).
Covered California officials eventually took the provider search tool off-line, and it hasn’t yet returned.
“People would look their provider up to make sure they could see who they want,” Hernandez said. “When the consumers would call those providers, those providers said they weren’t taking their insurance, or they weren’t taking new patients, or they weren’t accepting Covered California plans.”
Hernandez’ SB 137 would require insurers to maintain an accurate Web site database of providers, and to update the publicly-accessible information every week. It also requires provider directories to list provider languages spoken other than English.
“Look, if you’re going to have to purchase insurance, then the directories have to be accurate,” Hernandez said. “If you’re going to require people buy insurance, you have to at least make sure the information is presented accurately.”
Insurers have raised concerns that they only publish what providers give them, and that it’s unfair to put the onus of accuracy on insurance companies.
“What’s hard for them is getting information back from the provider, yes,” Hernandez said. “But when a provider signs a contract, they have to say what insurance they’re taking. I’m an optometrist, and I have to get re-authorized every six months. It’s a hassle, yes, but if I don’t do it they’ll take me off the Medi-Cal list. It’s the same thing here.”
The Senate agreed on Wednesday, on a 33-0 vote. The bill will appear next in the Assembly Committee on Health.