Legislature Passes SB 964 to Require Annual Reports from Insurers on Network Adequacy September 4, 2014 Advocacy, Covered California, Health Care Reform Covered California, network adequacy, SB 964 0 California legislature has passed a bill that would require Medi-Cal managed plans and insurers offering individual plans through Covered California to provide annual reports to the California Department of Managed Health Care (DMHC) about the adequacy of their provider networks. The bill also requires DMHC to post annual reviews regarding plan compliance on its website. SB 964—supported by SFMS and CMA—is now on the governor's desk awaiting his signature. With roughly 1.4 million Californians newly enrolled in Covered California products since October 2013, the importance of adequate provider networks has been paramount. New insurance products with narrowed networks have made it exceedingly difficult for both physicians and patients to find out who is in and out of these networks. A 2014 CMA survey found that more than half of physician respondents have experienced difficulty finding an in-network physician or facility to which they can refer their Covered California patients. There have also been several lawsuits filed by consumers against insurers for deceptive provider directories, and the state legislature has requested an audit of the Department of Health Care Services’ Medi-Cal provider directories for inaccuracies. Click here for more information on SB 964. Comments are closed.
