In the first quarter of 2025, Symphony focused on product enhancements that facilitate provider directory compliance and improve platform performance. We’re also excited to share more about how we’re expanding our solution to better serve dental and behavioral health markets. Finally, we hope to see some of you at CAHP’s Behavioral Health Seminar or APG’s Annual Conference in the coming months, where we’re sponsoring — read on for all the details!
Facilitating compliance through platform updates and industry support
SB 923: The TGI Inclusive Care Act
The TGI (transgender, gender-diverse, and intersex) Inclusive Care Act requires health plans to include a list of in-network providers who offer gender-affirming services in their directories and provide cultural competency training for patient-facing staff. The goal is to help TGI individuals access inclusive care. Symphony has updated our data model to support this regulation, ensuring clients can comply easily and efficiently. We can now:
Offer one confirmation noting completion of cultural competency training
Enable providers to attest to any of the 16 gender-affirming care services called out in SB 923 via our updated Areas of Expertise (AOE) code set
Enable providers to submit through an additional general ‘bucket’ category covering all other gender affirming care services
Share this information, once received, with plans via our regular outputs (XML/Recon report), making gender-affirming care updates simple
AB 280: Healthcare coverage: provider directories
Last year’s AB 236 is back under a new author. Similar to AB 236, AB 280 would require health plans to annually audit and verify the information in their provider directories. It would also establish accuracy benchmarks and associated penalties. The goal is to create a more effective enforcement mechanism for inaccurate provider directories, which create confusion and negatively impact patient access to critical healthcare services.
Symphony is monitoring the bill's progress and providing support to key stakeholders, drawing on our experience improving provider directory data quality and exchange through a centralized directory. We will keep clients posted on important updates throughout the year.
In the meantime, check out this fact sheet from Health Access for more information!
SB 137 Public Comment
DMHC held a public comment period from January 10 – February 24, 2025 to further specify SB 137 requirements, including the Uniform Data Standards and plan requirements for provider directories. Symphony provided comment on key areas, including:
Suggested alignment around our Tier 3 network definition and network granularity
Clarification around the expanded definition for “accepting new patients,” including wait times
Provider group name identification utilizing DMHC’s RBO (risk bearing organization) list
Tracking and reporting provider directory inaccuracies and Symphony’s data tuning policies
DMHC is currently reviewing all public comments. We will keep you updated on potential changes once any further rulemaking is complete.
Dental and Behavioral Health expansion
Symphony already facilitates data exchange for all provider types; however, we recognize that Dental and Behavioral Health markets face unique challenges in validating provider directory information. For example, directory errors for behavioral health providers are the highest of all specialties by some estimates – which is alarming given the current mental healthcare access crisis in the US.
Dental networks are also extremely complex, with most dentists contracting with over 20 plans and practicing at multiple locations. This makes directory information particularly challenging to validate, organize, and manage without additional support.
With our expertise simplifying complex data exchange processes to improve directory accuracy and patient access, Symphony is well poised to expand our solution to tackle these challenges in 2025. We are currently holding focus groups, exploring new reference sources for validation, and participating in relevant industry conferences.
Symphony is excited to sponsor this event, where we will join industry experts to discuss challenges, perspectives, and best practices for strengthening California's behavioral healthcare system and improving access.
APG Annual Conference | May 14-16, 2025 | San Diego, CA
IHA is sponsoring and presenting at America’s Physician Groups Annual Conference this year. Jeff Rideout, IHA President and CEO, and Dolores Yanagihara, IHA Vice President of AMP, will be discussing how physician organizations have been achieving superior performance with at-risk payment models. Additionally, stop by our booth to talk with Symphony and Availity team members about how Provider Data Management (PDM) can streamline provider data validation.
CAHP Annual Conference | September 29 – October 1, 2025 | Palm Desert, CA
Stay tuned for more information on our presence at CAHP! We’re sponsoring again this year and look forward to connecting with our clients and partners.
Q2 Attestation Schedule
Day 1: April 8
Day 30: May 20
Day 45: June 10
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