HB 71: Health Provider Directory and Access Amendments - Utah

Substitute #4 → Enrolled · 3 edits · Mar 17, 2026

MINOR

The bill text was finalized with minor formatting corrections to the section headers and a specific change to the hospital directory requirements. The most significant substantive change is the removal of a provision that required the Division of Professional Licensing to study the feasibility of a statewide behavioral health provider database, while the rest of the bill's requirements for insurers and providers remain unchanged.

Scope change

The bill's scope regarding the creation of a statewide behavioral health provider database was reduced by removing the mandate for the Division of Professional Licensing to study its feasibility and cost.

TIMELINE

Removed the requirement for the Division of Professional Licensing to convene a working group to study the feasibility and cost of a statewide behavioral health provider database.

TECHNICAL

Corrected a typo in the hospital directory requirements by removing a space between 'specialty' and 'type' in Subsection (5)(b)(ii).

Updated the timestamp at the end of the document from February 25, 2026, to March 10, 2026.

Substitute #3 → Substitute #4 · 4 edits

MODERATE

This bill version clarifies the enforcement of provider directories by shifting the responsibility for issuing educational letters to insurers rather than the commissioner, and it removes the requirement for the Division of Professional Licensing to report audit results to the Health and Human Services Interim Committee. The changes streamline the oversight process by allowing insurers to directly address repeated provider violations while reducing the reporting burden on the state committee.

Scope change

The bill's scope regarding enforcement mechanisms was narrowed by removing the commissioner's direct authority to issue educational letters for provider violations and eliminating a specific reporting requirement to the Health and Human Services Interim Committee.

ENFORCEMENT

The authority to issue an educational letter to a provider with a pattern of violations was transferred from the Insurance Commissioner to the insurer, which must now issue the letter and send a copy to the commissioner and the Division of Professional Licensing.

REQUIREMENT

The requirement for the Division of Professional Licensing to present audit reports and recommendations from the working group to the Health and Human Services Interim Committee was removed.

DEFINITION

The definition of 'Division' in Section 31A-22-664 was changed from the Division of Professional Licensing to the Division of Integrated Healthcare, aligning the agency responsible for the statewide database study with the agency overseeing Medicaid and integrated care.

TIMELINE

The requirement for the Division of Professional Licensing to report to the Health and Human Services Interim Committee was removed, eliminating the November 2026 reporting deadline for that specific action.

Substitute #2 → Substitute #3 · 2 edits

MINOR

The bill was updated to correct a typo in the Long Title description, changing 'Division of Professional Licensing' to 'Division' to ensure consistency with the statutory language. Additionally, a timestamp was added to the end of the document to reflect the latest version of the bill.

TECHNICAL

Corrected a typo in the Long Title where 'Division of Professional Licensing' was changed to 'Division' to match the specific agency name used in the statute.

Added a timestamp indicating the bill was updated on February 9, 2026, at 7:14 PM.

Substitute #1 → Substitute #2 · 8 edits

MODERATE

This revision softens the timeline for behavioral health access and provider directory updates while shifting enforcement authority from the Division of Professional Licensing to the Insurance Commissioner. It also adds specific reporting requirements for providers who fail to respond to verification requests and clarifies the legal liability of insurers and providers when patients rely on inaccurate directory information.

Scope change

The bill's scope regarding enforcement and oversight shifted from the Division of Professional Licensing to the Insurance Commissioner, and the definition of 'provider directory' was narrowed to exclude the Medicaid program.

TIMELINE

The deadline for insurers to establish procedures for out-of-network access changed from July 1, 2026, to January 1, 2027, and the definition of 'timely manner' for non-urgent services was extended from seven days to fifteen days.

REQUIREMENT

The deadline for insurers to update provider directories was reduced from every 60 days to every 90 days.

Insurers must now report the specific identities of providers who failed to respond to verification requests within the required timeframe.

The requirement for the Division of Professional Licensing to convene a working group was changed to require the division to present recommendations and reports from the commissioner to the Health and Human Services Interim Committee.

ENFORCEMENT

Authority to issue citations for repeated violations of provider verification rules was transferred from the Division of Professional Licensing to the Insurance Commissioner, who will instead issue educational letters.

New penalties were added allowing the commissioner to require insurers to cover costs and reimburse patients if they reasonably relied on inaccurate directory information, and to reimburse providers at in-network rates if they provided inaccurate information.

DEFINITION

The definition of 'provider directory' was updated to refer only to Section 31A-22-664, removing the reference to the Medicaid program requirements.

TECHNICAL

Several contact information fields in the provider directory requirements were updated to include the qualifier 'if applicable' for internet addresses and phone numbers.

Introduced → Substitute #1 · 7 edits

MODERATE

The bill was amended to expand its scope beyond private insurers to include the Public Employees' Benefit and Insurance Program (PEHP) and to authorize the Division of Professional Licensing to issue citations for repeated violations. It also added a requirement for the Division to study the feasibility of a statewide behavioral health provider database and adjusted several compliance deadlines and response times for insurers and providers.

Scope change

The bill's applicability was expanded to include the state's public employee health insurance program (PEHP), and the Division of Professional Licensing was given new enforcement authority to issue citations for repeated provider violations.

SCOPE

Added provisions allowing the Public Employees' Benefit and Insurance Program (PEHP) to adjust its business practices to mitigate financial impacts of the new requirements.

ENFORCEMENT

Authorized the Division of Professional Licensing to issue citations against providers who demonstrate a repeated pattern of failing to respond to verification requests.

REQUIREMENT

Required the Division of Professional Licensing to convene a working group to study the feasibility and cost of creating a statewide behavioral health provider database.

Extended the time providers have to respond to insurer verification requests from 10 business days to 15 business days.

Extended the time insurers have to investigate and correct inaccurate directory information from 2 business days to 5 business days.

TIMELINE

Changed the effective date for publishing provider directories from July 1, 2026, to January 1, 2027.

Adjusted the sunset date for the working group study from an unspecified date to July 1, 2027.

Health Provider Directory and Access Amendments

What changed between versions

How they voted

Actions timeline

Sponsors