Sens. Thom Tillis, Ron Wyden and Michael Bennet introduced the Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, which would strengthen requirements for Medicare Advantage plans to maintain accurate directories, according to an Oct. 27 news release from Mr. Tillis.
“Ghost networks” refers to providers listed in directories with inaccurate information, or who are no longer in business or not actually in a provider’s network. Inaccuracies are especially common in behavioral health networks, according to the senators.
A “secret shopper” study conducted by the Senate finance committee found around a third of providers listed in MA directories had inaccurate phone numbers or did not return calls.
The legislation would bar insurers from charging out-of-network rates for any provider listed in an online directory as in-network and direct CMS to publish guidance requiring accurate directories in Medicare Advantage.
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