AB 280 establishes provider directory reliance protections

What happened

California approved and filed AB 280 on September 27, with compliance under the amended directory provisions beginning July 1, 2027. The chaptered text directs DMHC to select a central utility and establish uniform standards for collecting, managing and checking provider-directory information. Subject to the specified exclusive-provider exception, plans and insurers must use the designated utility and submit directories for consistency reports; the methodology includes identifying inconsistent or incomplete entries, reviewing the report and describing remediation. Provider contracts must support information submission and identify the products in which a provider participates. The utility’s data does not excuse inaccurate network-status information in a carrier’s own directory. Qualifying nonprofit plans or insurers with at least 3.5 million enrollees or insureds in the specified geographic, mutually exclusive single-medical-group arrangement need not use the utility for providers exclusively serving, or employed by, the specified plan, insurer, medical group, facility or system. Providers contracted to multiple plans, or multiple insurers or plans under the insurer provision, remain subject to the utility requirement.

For covered benefits obtained in reasonable reliance on materially inaccurate, incomplete or misleading directory information, the regulatory finding triggers coverage and protection against charges beyond the applicable in-network share. Reimbursement is the agreed amount or, absent agreement, the reasonable and customary amount, less that share; covered-service status remains necessary. The text also addresses verification notices, accurate reinstatement requests within ten business days and a possible warning after five calendar days without a response. General acute care hospitals are exempt from specified confirmation, removal and reinstatement paragraphs, rather than the entire directory section. The amendments added by AB 280 do not apply to Medi-Cal managed care contracts. These future requirements call for product-specific preparation as of October 4.

Why it matters

Directory accuracy affects access, member liability and provider reimbursement. Utility integration must be matched to the actual product scope and reliance protections.

Implementation playbook

1. Confirm covered plan products, hospital exclusions and directory utility responsibilities. Managed Care · Due 2026-11-01
2. Map directory accuracy, notice, reliance and reinstatement workflows to the final provisions. Patient Access · Due 2027-03-01
3. Test integration and member-facing processes before the July 1 operative date. IT · Due 2027-07-01

Published long lead justification

The expressly stated July 1, 2027 operative date exceeds 180 days, while central directory utility integration and member reliance workflows require advance implementation planning.

Sources

• AB-280 Health care coverage: provider directories, bill historyOfficial · California Legislature · 2026-09-04 · Source review 2026-09-10
• AB-280 Health care coverage: provider directories, current bill text (09/01/26 - Enrolled)Official · California Legislature · 2026-09-01 · Source review 2026-09-10
• Governor Newsom issues legislative update 9.27.2026Official · Office of the Governor · 2026-09-27 · Source review 2026-10-04
• AB280 enacted final textOfficial · California Legislature · 2026-09-27 · Source review 2026-10-05