HB5313 Summary

• Network plans must post up-to-date, accurate, and complete provider directories electronically accessible to the general public without requiring account login or policy numbers.

• Network plans shall update online directories at least monthly within 10 business days of receiving provider notification of changes, and conduct annual audits of at least 25% of directories for accuracy.

• Provider directories must include searchable information for health care professionals (name, gender, office locations, specialty, languages spoken, telehealth availability, anticipated departure dates) and facilities (name, type, services, location, accreditation status).

• Network plans must provide printed copies of directories updated quarterly with quarterly errata sheets, include plain language descriptions of network criteria and tiered networks, and provide customer service contact information and dispute procedures for out-of-network charges.

• Directories must accommodate individuals with disabilities and limited English proficiency, and the Department shall conduct random audits of at least 10% of plans annually and make audit results publicly available.