Network Adequacy

Ghost networks haunt mental health access, study finds

A secret shopper study found less than a quarter of calls to mental health clinicians resulted in appointments, with directory errors and unreachable providers driving so-called "ghost" networks.

CMS proposes rule to clean up MA provider directories, shine light on PBMs

The proposed changes would implement key healthcare provisions in a government funding package from February. The brunt of the reforms would go into effect in 2028.

CMS proposes Medicare Advantage provider directory requirements for 2028

Medicare Advantage (MA) plans are set to face requirements aimed at improving the accuracy of provider directories, according to a proposed rule. Issued Oct. 16 by CMS, the proposed regulations would ...

CMS issues proposals to improve MA plan provider directory accuracy, PBM transparency requirements and reduce drug costs

CMS issues proposals to improve MA plan provider directory accuracy, PBM transparency requirements and reduce drug costs  American Hospital Association

12% of calls to mental health clinicians in Blue Cross directories yield appointments: Study

12% of calls to mental health clinicians in Blue Cross directories yield appointments: Study  Becker's Payer Issues

12% of calls to mental health clinicians in Blue Cross directories yield appointments: Study

Mental health 'ghost networks' limit access for commercially insured

Mental health 'ghost networks' limit access for commercially insured  Healthcare Finance News

CMS proposes to improve accuracy of Medicare Advantage provider directories

CMS proposes to improve accuracy of Medicare Advantage provider directories  Healthcare Finance News

UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1M

UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1M  NewsNation

UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1 million

UnitedHealthcare, Humana Medicare Advantage cancellations to affect 1 million  The Hill