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Senators Push Medicare Advantage Plans for Accurate Directories

Analysis  |  By Jay Asser  
   December 05, 2022

The Senate Finance Committee is calling for MA plans to get their provider directories in order with the aim of improving mental health parity in Medicare and Medicaid.

Senators released a discussion draft with policies to put access to mental health and substance use disorder services on the same level with physical healthcare — the fifth and final legislative draft the committee has released focusing on its bipartisan initiative of advancing mental health.

"Too often the notion of mental health parity falls short of reality," Senate Finance Committee chair Ron Wyden said in a statement. "These policies represent the first step towards addressing the mental health parity and ghost network challenges that I intend to build on in the coming months -- especially the challenges I hear about consistently from families at home who aren't able to find available mental health professionals covered in their insurance networks."

The policies include codifying existing requirements for MA plans to maintain updated provider contact information, whether a provider is accepting new patients, and in-network status changes within two days.

The discussion draft also calls for a Government Accountability Office study on the differences in enrollee cost-sharing and utilization management between behavioral and non-behavioral health services in MA and compared to free-for-service Medicare.

"These proposals will help us gather additional data and increase transparency to ensure Medicare beneficiaries have access to affordable mental health services, on par with their access to physical health services," committee ranking member Mike Crapo said.

Jay Asser is the contributing editor for strategy at HealthLeaders. 

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