AB 2586 Summary

• Requires health care service plans and health insurers that contract with providers to obtain department approval before implementing network modifications affecting more than 2,000 enrollees or insureds, and demonstrate the modified network meets access standards.

• Mandates plans and insurers provide enrollees and insureds with lists of contracting providers upon request, including hospital-based physicians and their specialties, updated at least quarterly.

• Prohibits plans and insurers from including deceased, retired, out-of-network, or noncontracting providers in their provider directories.

• Requires plans and insurers to establish mechanisms for enrollees, insureds, and providers to report provider directory errors, with confirmed errors corrected within 30 days.

• Requires the Department of Managed Health Care to review plans' compliance with provider listing requirements and network access standards during onsite medical surveys conducted at least once every three years.