Provider directory disclosures.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Appropriations
Take action
Record your position on this measure.
Create an account to take a stance, submit a written position, or contact your legislator.
Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
Assembly Bill 787 requires health care service plans and health insurers to include a clear statement in their provider directories advising enrollees to contact the plan for assistance in finding an in-network provider and explaining their rights regarding out-of-network coverage. The bill also mandates that the plan respond to such requests within a specified timeframe, providing a list of in-network providers accepting new patients. It aims to improve transparency and access to care by ensuring enrollees are aware of their options and rights.
Key provisions
- Requires provider directories to include a statement advising enrollees to contact the plan for assistance in finding an in-network provider.
- Specifies response times for enrollee requests for provider assistance (1-2 business days).
- Requires plans to provide a list of in-network providers accepting new patients within 2 business days for urgent requests and 5 business days for non-urgent requests.
- Mandates that plans update their provider directories regularly to reflect changes in provider availability.
- Establishes a process for providers to notify plans of changes in their acceptance of new patients.
- Requires plans to include specific information about language interpreter services and access to covered services in their directories.
- Addresses potential payment delays for providers if they fail to update directory information.
- Provides a mechanism for the Department of Health Care Services to review plan compliance with directory accuracy requirements.
Bill text
Read the latest version inline or switch to a previous version.
Text extraction is in progress. View the official source.
Sponsors
Official sponsors from legislative records.
1 on record
Primary sponsor
Arguments
Reasons offered for and against this legislation.
Arguments in favor
No arguments in favor have been submitted.
Submit yoursArguments opposed
No arguments opposed have been submitted.
Submit yours