November 5, 2024

There is an important article from The Guardian at the link below.  The topic is the ghost network problem that is (at best) delaying care for million’s of American’s in need of mental health and/or substance use disorder services.  As you may recall, the accuracy of NYS health plan directory information was the subject of last year’s secret shopper investigation and eventual report from the NYS Attorney General Tish James where the Office found serious problems with the information.  Here’s a look back at the Report:  https://ag.ny.gov/press-release/2023/attorney-general-james-uncovers-major-problems-accessing-mental-health-care

Tactics employed by some insurers to narrow the front door to care are growing more aggressive. When regulators uncover a systemwide problem that is so egregious and consequential, swift and forceful action should be taken.  To this point I have no knowledge of any meaningful ($$$) enforcement actions having been taken against any of the plans that were the subject of the AG’s Report.  I’d like to be wrong about this.

Here’s the article from The Guardian – it’s worth the read:https://amp-theguardian-com.cdn.ampproject.org/c/s/amp.theguardian.com/us-news/2024/nov/04/ghost-network-mental-healthcare-lawsuit