Department of Managed Health Care Releases Provider Directory Standards at End
On July 1, 2016, a new law took effect requiring insurance plans to ensure that
their provider directories are accurate. The law, SB 137, included multiple components
aimed at providing patients with more accurate and complete information. The
provisions of the law require providers to keep their information up-to-date
so that specific information is reflected accurately in their provider directory.
On December 30, 2016, the Department of Managed Health Care released the “Uniform
Provider Directory Standards” required under SB 137. The information contained
in the directory includes whether an individual provider is accepting new patients;
accepting existing patients; available by referral only; available only through
a hospital or facility; or not accepting new patients. The standards are classified
as minimum standards, and a health care service plan is permitted to implement
additional directory features that exceed the prescribed standards. Providers
are encouraged to review the amendments and/or provider manual updates closely
to ensure they can comply with the requirements. For a detailed explanation of
the directory requirements, click here.