Proposed Legislation Aims to Improve Provider Directories Accuracy

October 2019 ~

Two physician lawmakers have proposed new legislation that aims to improve the accuracy of information in health plan provider directories and protect patients from surprise out-of-network bills. The Improving Provider Directories Act (HR 4575) would require health plans to provide an avenue for people to report errors in provider directories, in a “highly visible way”.

The bill, introduced on September 30, would also require health plans to update inaccuracies within 30 days of error notification.

“Inaccurate provider directories can result in costly medical bills for patients who are acting responsibly and trying to stay in their network. As a physician for over 31 years, more than once during my time in practice was I incorrectly listed in a provider director, only leading to more patient confusion. Ensuring these directories are accurate is a commonsense reform that will allow patients to be better consumers of health care. That is why I am proud to introduce the Improving Provider Directories Act with Dr. Schrier, which will require health plans to keep updated provider directories so patients are well informed before getting treated. This bipartisan legislation goes hand-in-hand with the bipartisan effort to end surprise bills,” stated one of the bill’s cosponsors, Congressman Phil Roe, in a press release.

“When a patient is looking for a new doctor, they will often go to the online directory of their insurance provider to make sure the doctor is in-network. So imagine the surprise of the thousands of people a year when they get an ‘out-of-network’ bill for a doctor they were led to believe was in their insurance network,” said cosponsor, Congresswoman Kim Schrier. “Our bill will require these directories to be kept up-to-date and accurate.”

The proposal was referred to the Committee on Energy and Commerce, the Committees on Education and Labor, and Ways and Means, on September 27, as well as introduced in House.

Source(s): Becker’s Hospital Review; InsideHealthPolicy; McGuireWoods Consulting; Auburn Reporter;