Senators probe payer mental healthcare 'ghost networks'

A group of senators is seeking answers from major payers over "ghost networks" that make it difficult for patients to find in-network mental healthcare providers. 

A letter written by three lawmakers to UnitedHealthcare, Aetna, Elevance, Humana and the Blue Cross Blue Shield Association are in response to a March 2022 Government Accountability Office report on access and challenges for those seeking mental healthcare services, according to a Jan. 30 news release from Minnesota Sen. Tina Smith.  

Ghost networks arise when providers are listed as in network on an insurers' website but are no longer in network, accepting new patients or in business, according to the release. The senators said these networks can "sow confusion and frustration among patients who are often in need of immediate care."

"Patients who lack the time and resources to sift through inaccurate provider directories may ultimately choose to forgo or delay needed healthcare," the senators wrote in their letter. "Others may be forced to pay out of pocket for a provider."

The senators' letter asks the payers a series of questions, including what steps they take if a patient reports that a listed provider is no longer in network and what processes are in place to ensure a beneficiary is not charged out-of-network rates when receiving inaccurate information through directories.    

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