Insurance Update
Department of Managed Health Care Releases Provider Directory Standards at End of 2016

January 2017

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.