BOSTON, MA - Out-of-date and inaccurate health insurance provider directories appear to have a large number of in-network providers. In reality, the number is often much smaller, as providers may have moved, closed their practices, no longer accept new patients, or no longer participate in particular health insurance plans. These "ghost networks" are especially challenging for people seeking care for behavioral health conditions.
The Children's Mental Health Campaign (CMHC) applauds the Senate for passing An Act to increase consumer transparency about insurance provider networks (S. 2295) with unanimous support. This legislation requires that health insurance provider directories be easily searchable and available, as well as updated at least monthly to ensure accuracy. The bill also establishes a task force, chaired by the Division of Insurance, to make recommendations for regulations improving the accuracy of provider directories to ensure consistency across carriers.
"Many families and individuals seeking health care are unable to find a provider that meets their needs because of outdated and unclear provider directories," said Senator Jason Lewis, the lead sponsor of S. 2295. "Accurate provider directories are critical to improving access to timely and appropriate care to reduce disparities, to improve health outcomes, and to decrease unnecessary utilization of emergency and inpatient care. We are proud that the Senate took this important step forward today."
"Getting rid of stigma means that families and caregivers are seeking care for their children when they need it. They should be able to find it" said Representative Christine Barber, the lead sponsor of the House companion bill, H. 913. "I greatly appreciate the partnership and collaboration of all of the advocates, families and health organizations who have worked to make this a strong piece of legislation."
For many families, provider directories are the "front door" to getting services for their children with behavioral health conditions. Struggling through outdated information and refusals by multiple unavailable providers is exhausting and frightening, leaving children at risk for clinical deterioration and harm, often ending up with a visit to the emergency room, rather than getting appropriate care when it was needed.
"We're grateful to the Senate for recognizing that incomplete and inaccurate provider directories present a real barrier to accessing health care," said Amy Rosenthal, Executive Director of Health Care For All, a member of the leadership of the Children's Mental Health Campaign. "Advocates, providers, health insurers, and legislators came to the table to put forth legislation that improves the accuracy of provider directories so individuals and families can more easily find information about providers in their health plan's network that best meet their health, language, and accessibility needs."
The CMHC worked with health insurance carriers, providers, and legislators to develop the consensus language included in S. 2295. The CMHC looks forward to working with the House to ensure swift passage of this important legislation.
About the Children's Mental Health Campaign (CMHC):
The CMHC is a large statewide network that advocates for policy, systems, and practice solutions to ensure all children in Massachusetts have access to resources to prevent, diagnose, and treat mental health issues in a timely, effective, and compassionate way. The CMHC Executive Committee consists of six respected partner organizations: The Massachusetts Society for the Prevention of Cruelty to Children (MSPCC), Boston Children's Hospital, the Parent/Professional Advocacy League, Health Care For All, Health Law Advocates, and the Massachusetts Association for Mental Health. The CMHC network includes more than 160 organizations across Massachusetts.