*Many people seeking mental health care struggle to find a specialist covered by their insurance. Even with the large directories that some insurance plans provide, the process can be frustrating.
As The Guardian reports, common issues include providers not accepting new patients, inaccurate or disconnected phone numbers, doctors who have not accepted the insurance for some time, or even non-existent practitioners. This is referred to as a “ghost network.”
A new class action lawsuit claims that Anthem Blue Cross Blue Shield of New York has a ghost network that patient attorneys described it as “staggering.”
“A lot of people have encountered that kind of issue and they’re not talking about it, because mental health care is not something people are willing to talk about,” said Jacob Gardener, an attorney with Walden Macht Haran & Williams LLP, the law firm that filed the suit.
Attorneys representing anonymous plaintiffs conducted a simulation of a patient seeking a mental health provider through Anthem’s directory. They called the first 100 listed providers but could only secure appointments with seven. The others either no longer accepted the insurance, had incorrect specialties or phone numbers, or were not available for appointments in the next six months.
“These are deceptive business practices and these insurance companies should be held accountable in courts,” said Democratic senator Tina Smith of Minnesota. Per The Guardian, Smith introduced a bill that would impose fines on insurance companies for inaccurate directories, along with other measures.
Smith stated that insurers are “not following the letter and the spirit of the mental health parity law”, which mandates equal coverage for mental and physical health.
“It’s sort of sad to think we would have to pass a law to say, ‘You really have to do this and we will put penalties on you if you don’t,’ but I think that is another important step we need to take,” Smith said.
“We’re in a mental health crisis and health plans need to step up,” said Sue Abderholden, the executive director of NAMI Minnesota, or the National Alliance on Mental Illness. She said the problem of ghost networks is, in part, a problem of workforce dynamics.
Many mental health providers don’t see the value of being in insurance networks, according to a ProPublica investigation.
“As a result there are fewer practitioners who are paneled with insurance, which of course affects patient access,” said London Breedlove, a licensed psychologist and director of professional affairs at the Washington State Psychological Association.
“But you wouldn’t necessarily know that as a consumer. If you have a commercial health plan and go to your insurance website and say, ‘I want a provider’ and put in your zip code, it looks like there are a lot of people taking patients.”
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