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State provider directory laws require health plans and health insurers to publish and maintain online and printed provider directories with information about contracting providers who offer services to their enrollees or insureds. Contracting providers who maintain telehealth-only practices out of their homes and wish to keep their home addresses private should be aware of, and prepared to cite, the Uniform Provider Directory Standards.
With regard to provider directory displays of provider information, subsection (c)(7) of the standards states:
“Practice addresses and practice locations must be listed consistent with United States Postal Service conventions. If health care services are provided only in a patient’s home, or through telehealth services, this should be clearly noted and a practice address does not need to be listed.”
This provision means that while health plans and health insurers have a right to obtain providers’ practice addresses, plans and insurers are not required to include those addresses as part of the provider directory when providers are offering telehealth-only services. If providers are offering telehealth-only services, the standards simply require the plans and insurers to clearly state that fact within the provider directory.
These standards are set forth by the Department of Managed Health Care and the Department of Insurance in accordance with Health and Safety Code §1367.27(k).
For a complete discussion of provider directory law, see Sara Jasper’s article titled, “What Providers Need to Know About the Provider Directory Law.”
Members who are contracted with health plans and providing telehealth-only services may contact CAMFT at comments@camft.org if a health plan is requiring a practice address for their provider directory.
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