Inseparable, a national organization focused on closing the treatment gap for people with mental health conditions, improving crisis response, and supporting youth mental health, applauded the introduction of legislation in the General Assembly to improve access to mental health treatment by eliminating “ghost networks,” or provider networks that are filled with providers who are not actually in-network, not taking new patients, no longer in the same location, or not even practicing at all. The bill, HB5313, was recently introduced by State Representative Margaret Croke (IL-12) to ensure that enrollees seeking a mental health care provider can rely on accurate provider directories from their health plan. While insurance companies are required to make provider directories available for consumers when selecting a health plan or looking for an in-network provider, research shows that these directories frequently mischaracterize available providers or include “ghost networks” that are not actually available to people enrolled in a plan. Research also proves the importance of ensuring people get the treatment they need – delays can cause conditions to worsen, a rise in additional health concerns, and a dramatic increase in costs. HB5313 would expand what a plan must disclose in its provider directories to include a description of how to dispute charges for out-of-network providers that were incorrectly listed as in-network prior to the provision of care, including a phone number and email address. It would allow consumers to recoup out-of-pocket expenses if they were charged out-of-network costs for a provider that was listed as in-network in their provider directory. To learn more about HB5313, read more on ILGA.gov.
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