In just a Madaket Minute, we tackle a pressing issue: outdated provider directories in health plans.
Imagine needing urgent mental health support and finding none of the listed providers actually accept your insurance. That’s what happened to one patient, leading to a crisis situation and an ER visit. California Assemblymember Chris Holden’s proposed Assembly Bill 236 aims to fix this by ensuring insurance directories are 60% accurate by next year and 95% by 2028. The bill also proposes fines for insurers and protects patients from unexpected out-of-network bills.
Stay informed and see the full story in the Madaket Minute.
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Video Transcript:
Welcome to today’s Madaket Minute.
Have you ever been trapped in the vicious cycle of searching for a healthcare provider within your health plan’s network, only to find the information they provide is outdated?
Imagine one of your loved ones is having macinations of suicide and tries to find immediate help, but all the mental health providers listed in their directory don’t actually accept our insurance.
One patient in particular called a list of 50 mental health providers that were listed in Kaiser’s insurance plan, but not a single one would see her or they weren’t actually contracted with Kaiser at all!
Frustrated and already in dire condition, the patient gave up and tried to take her own life, winding up being admitted to a hospital’s emergency room to treat her.
California Assemblymember Chris Holden is pushing for Assembly Bill 236, which would require an insurer’s provider directory to be at least 60% accurate by this time next year and 95% accurate by July 1, 2028.
The proposed legislation would impose penalties on insurance companies, setting fines at a maximum of $10,000 per 1,000 members per year if they fail to meet specific standards. As a reference point, Kaiser reports it serves over 9 million people in California.
In addition, if the bill passes, any patients who mistakenly visit a doctor that’s not in their network because of incorrect data provided to them in the insurance directory cannot be billed out of network rates.
Californians await the final verdict of Bill 236, hoping for easier access to the care they desperately need—and deserve.
Thanks for joining us, see you next time.
