Staffers with the New York attorney general’s office called 396 mental health providers to schedule an appointment. Eighty-six percent were “unreachable, not in-network, or not accepting new patients.”
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Arizona regulators also called hundreds of mental health providers. They couldn’t schedule visits with nearly two out of every five providers they called.
Massachusetts’ attorney general investigated alleged efforts by insurers to restrict their customers’ mental health benefits. The insurers agreed to audit their provider listings but were largely allowed to police themselves.
Spokespeople for the state agencies told ProPublica that their “many actions” resulted in “significant accountability.” But ProPublica found that the actual actions taken so far do not match the regulators’ rhetoric.
Even when penalties for directory errors do happen, they are small and sporadic. In an average year, there are fewer than one-dozen fines issued by regulators. All those fines represent a fraction of 1% of the billions of dollars in profits made by the largest insurers.
Dr. Robert Trestman, a leading American Psychiatric Association expert on ghost networks, said state agencies have failed to enforce regulations. “They’re not doing their job. If they were, we would not have an ongoing problem.”
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