This bill addresses provider directories and timely access to behavioral health services.
This bill:
- requires covered insurers to:
assist enrollees in accessing behavioral health services in a timely manner; facilitate an insured obtaining behavioral health services from an out-of-network provider if an in-network provider is not available in a timely manner; publish health care provider directories; regularly update health care provider directories; andtake certain steps to ensure the accuracy of provider directories;
- permits the Public Employees' Benefit and Insurance Program (program) to adjust the program's business practice to mitigate financial impacts of certain provisions;
- authorizes Utah's insurance commissioner to make rules to implement certain provisions of this bill;
- authorizes the Division of Professional Licensing (division) to issue citation for a demonstrated pattern of violations of certain provisions;
- requires providers to respond to an insurer's request for verification of provider directory information within a certain period of time;
- requires the Department of Health and Human Services to establish requirements for the state Medicaid program that are substantially similar to the requirements for private insurers related to timely access to behavioral health services and health care provider directories;
- requires the division to convene a working group to study the feasibility and cost of creating and maintaining a statewide behavioral health provider directory (working group) and provide recommendations to the Health and Human Services Interim Committee;
- provides a sunset date for the working group; and
- defines terms.
Recommended by: Health and Human Services Interim CommitteeStatutes affected:
Introduced: 58-1-501, 58-1-502
Substitute #1: 63I-2-258