Committee advances bill to tighten behavioral‑health provider directories amid industry concerns
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Summary
Lawmakers advanced amendments requiring publicly accessible, frequently updated behavioral‑health provider directories, expanded network‑adequacy provisions and single‑case agreement processes; providers and insurers asked for refinement to avoid license penalties and unintended access impacts.
Representative Eliason introduced amendments aimed at reducing so‑called "ghost providers" in behavioral‑health directories by requiring insurers and Medicaid managed programs to publish searchable, downloadable directories updated every 60 days, and to provide single‑case agreements when networks lack a needed provider.
The bill would also direct the insurance commissioner to implement the provisions and require the Medicaid program to adopt substantially similar requirements. Representative Eliason said the measure responds to an OLAG audit that found roughly 68–69% of sampled directory entries were not viable leads for members seeking care.
Public witnesses cautioned the committee to avoid language that could treat nonresponse to insurers as professional misconduct. Michelle Macomber (Utah Medical Association) and a coalition of counselors urged refinements so that administrative lapses or contractual issues do not trigger license enforcement. Insurers said directory accuracy depends on provider responses but supported the goal of improved access. Kara Cheevers (Inseparable) and others argued that better directories reduce delays, out‑of‑network use and higher patient costs.
Committee members discussed adding a "limited availability" status and other pragmatic steps to reduce false positives in directories and asked the sponsor to work with providers and carriers on implementation details. Representative Clancy moved and the committee favorably moved the bill, with sponsors saying they intend to return refined language to the committee.
