HB 5382 Summary

• Requires health carriers and participating providers to provide at least 60 days' written notice before removing a provider from the network or departing, with the health carrier notifying affected patients within 30 days of such notice.

• Expands the definition of "active course of treatment" to include treatment for conditions managed over the preceding 12 months and evaluation appointments scheduled before provider removal or departure.

• Requires the Insurance Commissioner to redetermine network sufficiency when a health system leaves a carrier's network and to post results on the Insurance Department website.

• Mandates health carriers provide covered persons with detailed information about continuity of care procedures, including request forms, filing methods, expedited processes, decision timelines, and appeal rights.

• Establishes that continuity of care requests are automatically approved if the health carrier fails to notify the covered person of a decision, and extends continuity periods through the postpartum period for pregnant patients.

• Effective July 1, 2018.