CA AB280

Requires health care service plans and health insurers to meet escalating provider directory accuracy benchmarks: 60% by July 1, 2026, 80% by July 1, 2027, 90% by July 1, 2028, and 95% by July 1, 2029, with administrative penalties for non-compliance.

Mandates annual verification of provider directory information and allows plans/insurers to remove providers who fail to respond to verification requests within 30 business days after a 10-business-day advance notice period.

Protects consumers who rely on inaccurate directory information by requiring plans/insurers to cover services at in-network rates, hold enrollees harmless for amounts beyond in-network cost-sharing, and reimburse providers at out-of-network rates.

Requires plans/insurers to respond within two business days to telephone requests about provider network status and whether providers are accepting new patients, with written follow-up confirmation.

Authorizes the Department of Managed Health Care and Department of Insurance to update uniform directory formats and establish or designate a central utility for provider directory information verification by January 1, 2026.