AB 280 — Health care coverage: provider directories.
Last action — Enrolled and presented to the Governor at 4 p.m.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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✓In Committee
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✓Passed Assembly
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✓Passed Senate
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5To Executive
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6Enacted
This bill has been sent to the executive. Introduced January 21, 2025. It awaits signature.
Next likely step: the executive signs it into law or issues a veto.
Prognosis
Where this bill stands today.
Odds of enactment
ModerateHow often bills like it became law.
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To Executive
Current position in the legislative process.
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1 sponsor
1 primary, 0 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (1 D).
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Cleared a recorded vote
Passed 9 recorded votes so far.
Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.
In plain language
This bill standardizes provider directories for health care plans to improve accuracy and reliability.
The bill requires health care service plans and insurers to use a central utility for managing provider directories. It aims to ensure that information is accurate and provides coverage for services when inaccurate information is relied upon by enrollees.
What this means for you
- Patients: If you rely on provider directories for health care services, this bill aims to ensure the information you find is accurate.
Summary
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan and a health insurer that contracts with providers for alternative rates of payment to publish and maintain a provider directory or directories with information on contracting providers that deliver health care services enrollees or insureds, and requires a health care service plan and health insurer to regularly update its printed and online provider directory or directories, as specified. Existing law authorizes the departments to require a plan or insurer to provide coverage for all covered health care services provided to an enrollee or insured who reasonably relied on materially inaccurate, incomplete, or misleading information contained in a plan's or insurer's provider directory or directories. This bill would require the Department of Managed Health Care to select a central utility and develop uniform provider directory standards requiring a health care service plan to use the designated central utility to collect, manage, and verify the consistency and completeness of their provider directories. The bill would also require health insurers to use the designated central utility and follow the uniform provider directory standards. The bill would require plans and health insurers to submit their provider directories to the central utility for analysis, and would require the central utility to create a consistency report for each directory. This bill would require a plan or insurer to provide coverage for all covered benefits provided to an enrollee or insured who reasonably relied on inaccurate, incomplete, or misleading information contained in the plan's or insurer's provider directory or directories and to reimburse the provider the agreed upon amount, or, if none, a reasonable and customary amount, as specified, for those services. The bill would prohibit a provider from collecting an additional amount from an enrollee or insured other than the applicable in-network cost sharing, which would count toward the in-network deductible and out-of-pocket maximum. The bill would require the health care service plan or the insurer, as applicable, to ensure the accuracy of a request to add back a provider who was previously removed from a directory and approve the request within 10 business days of receipt, if accurate. The bill would authorize a health care service plan or insurer to include a specified statement in the provider listing before removing the provider from the directory if the provider does not respond within 5 calendar days of the plan's or insurer's annual notification. The bill would require a plan or insurer to comply with its provisions on and after July 1, 2027. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Bill Text
- Chaptered 09/27/26 - Chaptered html September 27, 2026
- Enrolled 09/01/26 - Enrolled html September 01, 2026
- Amended 08/21/26 - Amended Senate html August 21, 2026
- Amended 07/15/25 - Amended Senate Current pdf July 15, 2025
- Amended 06/30/25 - Amended Senate pdf June 30, 2025
- Amended 05/23/25 - Amended Assembly pdf May 23, 2025
- Introduced 01/21/25 - Introduced pdf January 21, 2025
- AB280 View text html
Action History
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Enrolled and presented to the Governor at 4 p.m.
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Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 64. Noes 2.).
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In Assembly. Concurrence in Senate amendments pending.
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Read third time. Passed. Ordered to the Assembly. (Ayes 31. Noes 3.).
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Read second time. Ordered to third reading.
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Read second time and amended. Ordered returned to second reading.
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Ordered to second reading.
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From inactive file.
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Ordered to inactive file at the request of Senator Durazo.
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Read second time. Ordered to third reading.
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From committee: Do pass. (Ayes 5. Noes 0.) (August 29).
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In committee: Referred to suspense file.
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Read second time and amended. Re-referred to Com. on APPR.
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From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0.) (July 9).
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From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH.
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Referred to Com. on HEALTH.
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In Senate. Read first time. To Com. on RLS. for assignment.
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Read third time. Passed. Ordered to the Senate. (Ayes 61. Noes 7. Page 1926.)
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Read second time. Ordered to third reading.
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Read second time and amended. Ordered returned to second reading.
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From committee: Amend, and do pass as amended. (Ayes 11. Noes 1.) (May 23).
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Assembly Rule 63 suspended. (Ayes 51. Noes 16. Page 1644.)
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In committee: Set, first hearing. Referred to suspense file.
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From committee: Do pass and re-refer to Com. on APPR. (Ayes 11. Noes 0.) (April 1). Re-referred to Com. on APPR.
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Referred to Com. on HEALTH.
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From printer. May be heard in committee February 21.
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Read first time. To print.
Sponsors
- Cecilia M. Aguiar-Curry · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 121 not signed on · 11 voted No
Sponsors (1)
- Aguiar-Curry, Cecilia M. Democratic
Co-sponsors (0)
None.
Not signed on (121)
121 members have not signed on to this bill.
Show all 121 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 5 | 2 | 0 | 11 |
| Democratic | 53 | 0 | 0 | 1 |
| Unaffiliated | 6 | 0 | 0 | 1 |
| Total | 64 | 2 | 0 | 13 |
| % of votes cast | 81% | 3% | 0% | 16% |
How each member voted (79)
| Member | Party | Vote |
|---|---|---|
| Patterson | — | Not Voting |
| Ávila Farías | — | Yea |
| Rivas | — | Yea |
| Carrillo | — | Yea |
| Fong | — | Yea |
| Garcia | — | Yea |
| Lowenthal | — | Yea |
| Addis, Dawn | Democratic | Yea |
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Ahrens, Patrick | Democratic | Yea |
| Alvarez, David | Democratic | Yea |
| Arambula, Joaquin | Democratic | Yea |
| Bains, Jasmeet | Democratic | Yea |
| Bauer-Kahan, Rebecca | Democratic | Yea |
| Bennett, Steve | Democratic | Yea |
| Berman, Marc | Democratic | Yea |
| Boerner, Tasha | Democratic | Yea |
| Bonta, Mia | Democratic | Yea |
| Bryan, Isaac G. | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Connolly, Damon | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Gabriel, Jesse | Democratic | Yea |
| Gipson, Mike A. | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Haney, Matt | Democratic | Yea |
| Harabedian, John | Democratic | Yea |
| Hart, Gregg | Democratic | Yea |
| Irwin, Jacqui | Democratic | Yea |
| Jackson, Corey A. | Democratic | Yea |
| Kalra, Ash | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Lee, Alex | Democratic | Yea |
| McKinnor, Tina | Democratic | Not Voting |
| Muratsuchi, Al | Democratic | Yea |
| Nguyen, Stephanie | Democratic | Yea |
| Ortega, Liz | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Papan, Diane | Democratic | Yea |
| Patel, Darshana R. | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Petrie-Norris, Cottie | Democratic | Yea |
| Quirk-Silva, Sharon | Democratic | Yea |
| Ramos, James C. | Democratic | Yea |
| Ransom, Rhodesia | Democratic | Yea |
| Rodriguez, Celeste | Democratic | Yea |
| Rodriguez, Michelle | Democratic | Yea |
| Rogers, Chris | Democratic | Yea |
| Rubio, Blanca E. | Democratic | Yea |
| Schiavo, Pilar | Democratic | Yea |
| Schultz, Nick | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Soria, Esmeralda | Democratic | Yea |
| Stefani, Catherine | Democratic | Yea |
| Valencia, Avelino | Democratic | Yea |
| Ward, Christopher M. | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Wilson, Lori D. | Democratic | Yea |
| Zbur, Rick Chavez | Democratic | Yea |
| Alanis, Juan | Republican | Yea |
| Castillo, Leticia | Republican | Not Voting |
| Chen, Phillip | Republican | Not Voting |
| Davies, Laurie | Republican | Yea |
| DeMaio, Carl | Republican | Nay |
| Dixon, Diane | Republican | Not Voting |
| Ellis, Stan | Republican | Not Voting |
| Flora, Heath | Republican | Yea |
| Gonzalez, Jeff | Republican | Yea |
| Hadwick, Heather | Republican | Not Voting |
| Hoover, Josh | Republican | Not Voting |
| Johnson, Natasha | Republican | Not Voting |
| Lackey, Tom | Republican | Not Voting |
| Macedo, Alexandra | Republican | Not Voting |
| Sanchez, Kate | Republican | Nay |
| Ta, Tri | Republican | Not Voting |
| Tangipa, David J. | Republican | Not Voting |
| Wallis, Greg | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 5 | 0 | 0 | 1 |
| Republican | 2 | 3 | 0 | 4 |
| Democratic | 25 | 0 | 0 | 0 |
| Total | 32 | 3 | 0 | 5 |
| % of votes cast | 80% | 8% | 0% | 13% |
How each member voted (40)
| Member | Party | Vote |
|---|---|---|
| Allen | — | Yea |
| Gonzalez | — | Yea |
| Ochoa Bogh | — | Not Voting |
| Pérez | — | Yea |
| Rubio | — | Yea |
| Weber Pierson | — | Yea |
| Archuleta, Bob | Democratic | Yea |
| Arreguín, Jesse | Democratic | Yea |
| Ashby, Angelique V. | Democratic | Yea |
| Becker, Josh | Democratic | Yea |
| Blakespear, Catherine S. | Democratic | Yea |
| Cabaldon, Christopher | Democratic | Yea |
| Caballero, Anna M. | Democratic | Yea |
| Cervantes, Sabrina | Democratic | Yea |
| Cortese, Dave | Democratic | Yea |
| Durazo, Maria Elena | Democratic | Yea |
| Grayson, Timothy S. | Democratic | Yea |
| Hurtado, Melissa | Democratic | Yea |
| Laird, John | Democratic | Yea |
| Limón, Monique | Democratic | Yea |
| McGuire, Mike | Democratic | Yea |
| McNerney, Jerry | Democratic | Yea |
| Menjivar, Caroline | Democratic | Yea |
| Padilla, Stephen C. | Democratic | Yea |
| Reyes, Eloise Gómez | Democratic | Yea |
| Richardson, Laura | Democratic | Yea |
| Smallwood-Cuevas, Lola | Democratic | Yea |
| Stern, Henry I. | Democratic | Yea |
| Umberg, Thomas J. | Democratic | Yea |
| Wahab, Aisha | Democratic | Yea |
| Wiener, Scott D. | Democratic | Yea |
| Alvarado-Gil, Marie | Republican | Nay |
| Choi, Steven S. | Republican | Not Voting |
| Dahle, Megan | Republican | Yea |
| Grove, Shannon | Republican | Yea |
| Jones, Brian W. | Republican | Nay |
| Niello, Roger W. | Republican | Not Voting |
| Seyarto, Kelly | Republican | Nay |
| Strickland, Tony | Republican | Not Voting |
| Valladares, Suzette Martinez | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 30 | 0 | 0 | 0 |
| Republican | 2 | 3 | 0 | 5 |
| Total | 32 | 3 | 0 | 5 |
| % of votes cast | 80% | 8% | 0% | 13% |
How each member voted (40)
| Member | Party | Vote |
|---|---|---|
| Allen, Benjamin | Democratic | Yea |
| Archuleta, Bob | Democratic | Yea |
| Arreguín, Jesse | Democratic | Yea |
| Ashby, Angelique V. | Democratic | Yea |
| Becker, Josh | Democratic | Yea |
| Blakespear, Catherine S. | Democratic | Yea |
| Cabaldon, Christopher | Democratic | Yea |
| Caballero, Anna M. | Democratic | Yea |
| Cervantes, Sabrina | Democratic | Yea |
| Cortese, Dave | Democratic | Yea |
| Durazo, Maria Elena | Democratic | Yea |
| Gonzalez, Lena A. | Democratic | Yea |
| Grayson, Timothy S. | Democratic | Yea |
| Hurtado, Melissa | Democratic | Yea |
| Laird, John | Democratic | Yea |
| Limón, Monique | Democratic | Yea |
| McGuire, Mike | Democratic | Yea |
| McNerney, Jerry | Democratic | Yea |
| Menjivar, Caroline | Democratic | Yea |
| Padilla, Stephen C. | Democratic | Yea |
| Pérez, Sasha Renée | Democratic | Yea |
| Reyes, Eloise Gómez | Democratic | Yea |
| Richardson, Laura | Democratic | Yea |
| Rubio, Susan | Democratic | Yea |
| Smallwood-Cuevas, Lola | Democratic | Yea |
| Stern, Henry I. | Democratic | Yea |
| Umberg, Thomas J. | Democratic | Yea |
| Wahab, Aisha | Democratic | Yea |
| Weber Pierson, M.D., Akilah | Democratic | Yea |
| Wiener, Scott D. | Democratic | Yea |
| Alvarado-Gil, Marie | Republican | Nay |
| Choi, Steven S. | Republican | Not Voting |
| Dahle, Megan | Republican | Yea |
| Grove, Shannon | Republican | Yea |
| Jones, Brian W. | Republican | Nay |
| Niello, Roger W. | Republican | Not Voting |
| Ochoa Bogh, Rosilicie | Republican | Not Voting |
| Seyarto, Kelly | Republican | Nay |
| Strickland, Tony | Republican | Not Voting |
| Valladares, Suzette Martinez | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 5 | 0 | 0 | 0 |
| Republican | 0 | 0 | 0 | 2 |
| Total | 5 | 0 | 0 | 2 |
| % of votes cast | 71% | 0% | 0% | 29% |
How each member voted (7)
| Member | Party | Vote |
|---|---|---|
| Cabaldon, Christopher | Democratic | Yea |
| Caballero, Anna M. | Democratic | Yea |
| Grayson, Timothy S. | Democratic | Yea |
| Richardson, Laura | Democratic | Yea |
| Wahab, Aisha | Democratic | Yea |
| Dahle, Megan | Republican | Not Voting |
| Seyarto, Kelly | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 5 | 0 | 0 | 0 |
| Republican | 2 | 0 | 0 | 0 |
| Total | 7 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (7)
| Member | Party | Vote |
|---|---|---|
| Cabaldon, Christopher | Democratic | Yea |
| Caballero, Anna M. | Democratic | Yea |
| Grayson, Timothy S. | Democratic | Yea |
| Richardson, Laura | Democratic | Yea |
| Wahab, Aisha | Democratic | Yea |
| Dahle, Megan | Republican | Yea |
| Seyarto, Kelly | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 8 | 0 | 0 | 1 |
| Republican | 0 | 0 | 0 | 2 |
| Total | 8 | 0 | 0 | 3 |
| % of votes cast | 73% | 0% | 0% | 27% |
How each member voted (11)
| Member | Party | Vote |
|---|---|---|
| Durazo, Maria Elena | Democratic | Yea |
| Gonzalez, Lena A. | Democratic | Yea |
| Limón, Monique | Democratic | Yea |
| Menjivar, Caroline | Democratic | Yea |
| Padilla, Stephen C. | Democratic | Yea |
| Richardson, Laura | Democratic | Yea |
| Rubio, Susan | Democratic | Yea |
| Weber Pierson, M.D., Akilah | Democratic | Not Voting |
| Wiener, Scott D. | Democratic | Yea |
| Grove, Shannon | Republican | Not Voting |
| Valladares, Suzette Martinez | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 58 | 0 | 0 | 1 |
| Republican | 2 | 7 | 0 | 10 |
| Unaffiliated | 1 | 0 | 0 | 0 |
| Total | 61 | 7 | 0 | 11 |
| % of votes cast | 77% | 9% | 0% | 14% |
How each member voted (79)
| Member | Party | Vote |
|---|---|---|
| Ávila Farías | — | Yea |
| Addis, Dawn | Democratic | Yea |
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Ahrens, Patrick | Democratic | Yea |
| Alvarez, David | Democratic | Yea |
| Arambula, Joaquin | Democratic | Yea |
| Bains, Jasmeet | Democratic | Yea |
| Bauer-Kahan, Rebecca | Democratic | Yea |
| Bennett, Steve | Democratic | Not Voting |
| Berman, Marc | Democratic | Yea |
| Boerner, Tasha | Democratic | Yea |
| Bonta, Mia | Democratic | Yea |
| Bryan, Isaac G. | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Carrillo, Juan | Democratic | Yea |
| Connolly, Damon | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Fong, Mike | Democratic | Yea |
| Gabriel, Jesse | Democratic | Yea |
| Garcia, Robert | Democratic | Yea |
| Gipson, Mike A. | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Haney, Matt | Democratic | Yea |
| Harabedian, John | Democratic | Yea |
| Hart, Gregg | Democratic | Yea |
| Irwin, Jacqui | Democratic | Yea |
| Jackson, Corey A. | Democratic | Yea |
| Kalra, Ash | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Lee, Alex | Democratic | Yea |
| Lowenthal, Josh | Democratic | Yea |
| McKinnor, Tina | Democratic | Yea |
| Muratsuchi, Al | Democratic | Yea |
| Nguyen, Stephanie | Democratic | Yea |
| Ortega, Liz | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Papan, Diane | Democratic | Yea |
| Patel, Darshana R. | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Petrie-Norris, Cottie | Democratic | Yea |
| Quirk-Silva, Sharon | Democratic | Yea |
| Ramos, James C. | Democratic | Yea |
| Ransom, Rhodesia | Democratic | Yea |
| Rivas, Robert | Democratic | Yea |
| Rodriguez, Celeste | Democratic | Yea |
| Rodriguez, Michelle | Democratic | Yea |
| Rogers, Chris | Democratic | Yea |
| Rubio, Blanca E. | Democratic | Yea |
| Schiavo, Pilar | Democratic | Yea |
| Schultz, Nick | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Soria, Esmeralda | Democratic | Yea |
| Stefani, Catherine | Democratic | Yea |
| Valencia, Avelino | Democratic | Yea |
| Ward, Christopher M. | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Wilson, Lori D. | Democratic | Yea |
| Zbur, Rick Chavez | Democratic | Yea |
| Alanis, Juan | Republican | Nay |
| Castillo, Leticia | Republican | Not Voting |
| Chen, Phillip | Republican | Yea |
| Davies, Laurie | Republican | Nay |
| DeMaio, Carl | Republican | Nay |
| Dixon, Diane | Republican | Nay |
| Ellis, Stan | Republican | Not Voting |
| Flora, Heath | Republican | Not Voting |
| Gallagher, James | Republican | Yea |
| Gonzalez, Jeff | Republican | Not Voting |
| Hadwick, Heather | Republican | Not Voting |
| Hoover, Josh | Republican | Nay |
| Lackey, Tom | Republican | Not Voting |
| Macedo, Alexandra | Republican | Not Voting |
| Patterson, Joe | Republican | Not Voting |
| Sanchez, Kate | Republican | Not Voting |
| Ta, Tri | Republican | Not Voting |
| Tangipa, David J. | Republican | Nay |
| Wallis, Greg | Republican | Nay |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 11 | 0 | 0 | 0 |
| Republican | 0 | 1 | 0 | 3 |
| Total | 11 | 1 | 0 | 3 |
| % of votes cast | 73% | 7% | 0% | 20% |
How each member voted (15)
| Member | Party | Vote |
|---|---|---|
| Arambula, Joaquin | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Fong, Mike | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Hart, Gregg | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Dixon, Diane | Republican | Nay |
| Sanchez, Kate | Republican | Not Voting |
| Ta, Tri | Republican | Not Voting |
| Tangipa, David J. | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 11 | 0 | 0 | 1 |
| Republican | 0 | 0 | 0 | 3 |
| Total | 11 | 0 | 0 | 4 |
| % of votes cast | 73% | 0% | 0% | 27% |
How each member voted (15)
| Member | Party | Vote |
|---|---|---|
| Addis, Dawn | Democratic | Yea |
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Arambula, Joaquin | Democratic | Yea |
| Bonta, Mia | Democratic | Yea |
| Carrillo, Juan | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Patel, Darshana R. | Democratic | Yea |
| Rodriguez, Celeste | Democratic | Yea |
| Schiavo, Pilar | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Not Voting |
| Stefani, Catherine | Democratic | Yea |
| Chen, Phillip | Republican | Not Voting |
| Flora, Heath | Republican | Not Voting |
| Sanchez, Kate | Republican | Not Voting |
Subjects
Frequently asked questions
- What does AB 280 do?
- Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan and a health insurer that contracts with providers for alternative rates of payment to publish and maintain a provider directory or directories with information on contracting providers that deliver health care services enrollees or insureds, and requires a health care service plan and health insurer to regularly update its printed and online provider directory or directories, as specified. Existing law authorizes the departments to require a plan or insurer to provide coverage for all covered health care services provided to an enrollee or insured who reasonably relied on materially inaccurate, incomplete, or misleading information contained in a plan's or insurer's provider directory or directories. This bill would require the Department of Managed Health Care to select a central utility and develop uniform provider directory standards requiring a health care service plan to use the designated central utility to collect, manage, and verify the consistency and completeness of their provider directories. The bill would also require health insurers to use the designated central utility and follow the uniform provider directory standards. The bill would require plans and health insurers to submit their provider directories to the central utility for analysis, and would require the central utility to create a consistency report for each directory. This bill would require a plan or insurer to provide coverage for all covered benefits provided to an enrollee or insured who reasonably relied on inaccurate, incomplete, or misleading information contained in the plan's or insurer's provider directory or directories and to reimburse the provider the agreed upon amount, or, if none, a reasonable and customary amount, as specified, for those services. The bill would prohibit a provider from collecting an additional amount from an enrollee or insured other than the applicable in-network cost sharing, which would count toward the in-network deductible and out-of-pocket maximum. The bill would require the health care service plan or the insurer, as applicable, to ensure the accuracy of a request to add back a provider who was previously removed from a directory and approve the request within 10 business days of receipt, if accurate. The bill would authorize a health care service plan or insurer to include a specified statement in the provider listing before removing the provider from the directory if the provider does not respond within 5 calendar days of the plan's or insurer's annual notification. The bill would require a plan or insurer to comply with its provisions on and after July 1, 2027. Because a violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
- Who sponsors AB 280?
- AB 280 is sponsored by Aguiar-Curry, Cecilia M. (Democratic).
- What is the current status of AB 280?
- This bill has been sent to the executive. Introduced January 21, 2025. It awaits signature.
- Where can I track AB 280?
- Track AB 280 free on One Click Politics — get push/email alerts when it moves.
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