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Kuster helps introduce legislation to tackle ghost networks, increase health care transparency

By Staff | Mar 23, 2024

WASHINGTON – U.S. Rep. Annie Kuster (NH-02) helped introduce bipartisan legislation to empower patients with up-to-date information on health care providers covered by their insurance plans. The Requiring Enhanced and Accurate Lists (REAL) Health Providers Act would require Medicare Advantage insurance plans to update their provider directories annually starting in 2026. This legislation is co-led by Reps. Jimmy Panetta (CA-19), Greg Murphy (NC-03), Brad Schneider (IL-10), and Brian Fitzpatrick (PA-01).

Patients rely on provider directories from Medicare Advantage insurance plans to find in-network providers. However, many insurers fail to update these directories, creating ghost networks of providers who are listed as options for care despite no longer practicing, no longer accepting patients, or not being part of the plan’s network.

“Seniors and folks enrolled in Medicare Advantage deserve to know which doctors are in their network and accepting new patients as they navigate their health care coverage. Access to accurate provider directories is essential for receiving timely care. We can and must do more to simplify our health care landscape,” said Rep. Kuster. “I am proud to help introduce the REAL Health Providers Act to protect seniors from unexpected health care costs and build a system that is easier to navigate for all.”

A recent study looking at the accuracy of provider directories found that 33% of listed providers were inaccurate, non-working numbers. More than 80% of listed, in-network mental health providers were either unreachable, not accepting new patients, or not in-network. These inaccuracies disproportionately harm seniors, disabled individuals, and Americans living with mental health challenges.

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