The California Association of Health Plans and the California Medical Association opposed the legislation.
Existing state law requires payers to publish basic provider information in their directories, including names, addresses, and contact information. The law also requires payers to make regular updates. If a member visits a provider listed as in-network in the insurer’s directory, but the provider is out-of-network, the insurer must pay as if the provider was in-network.
Error rates within insurer’s directories have persisted however, and the new law would have authorized the state to mandate that insurers use a third-party provider directory utility, allowing providers to update their information once for all contracted plans. The legislation also would have established annually increasing accuracy benchmarks (and corresponding penalties) starting at 60% accuracy, and building to 95% percent accuracy by 2028.
The bill was held in the California Senate Appropriations Committee suspense file on Aug. 15.
