Proposal in California would require insurers to update provider lists
California lawmakers have proposed legislation that would require insurers to update their provider lists weekly and make them more available online, reported the Los Angeles Times.
The proposal from Sen. Ed Hernandez (D), SB 137, would also mandate insurers to post whether doctors accept new patients in addition to which languages they speak.
"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 told the Times.
This proposal comes after a California Department of Managed Health Care investigation into whether Anthem Blue Cross and Blue Shield of California misled consumers about its networks and thus made it too difficult for them to get treated. This often caused patients to pay more for out-of-network procedures. The proposal also follows an Office of Inspector General report, which found that many insurers' Medicaid provider directories are inaccurate.
More than 25 percent of physicians Anthem listed weren't taking insurance plans listed on Covered California, the state's health insurance exchange, or were no longer located at the location listed by the companies, reported the Times.
Consumer advocates said that provider directories, originally written on paper booklets, are not keeping up with the demands of individuals who search for physician information online.
As of late, the industry has been cracking down on narrow networks. In two separate lawsuits, Consumer Watchdog alleged that Cigna and Blue Shield of California misled consumers with a "bait and switch" scheme. Their plans offered inadequate provider networks and incorrectly advertised which providers were in network; when consumers learned that their doctors weren't covered in the plans, it was too late to switch insurers, FierceHealthPayer previously reported.
- here's the Times article
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