Senator’s bipartisan legislation would improve Americans’ access to health care amid national mental health crisis
As Coloradans and residents of Chaffee County know, the mental health crisis in this country is growing, not decreasing. A hidden demographic is suffering, largely in silence: the elderly.
Yesterday, U.S. Senators Michael Bennet (D-Colo.), Thom Tillis (RN.C.) and Ron Wyden (D-Ore.) introduced the Medical Provider List Requirements Act Advanced and accurate (REAL) data to ensure Medicare Advantage plans maintain accurate provider directories and protect seniors from unexpected health care costs.
Bennet said we are experiencing a major mental health crisis across America but instead of getting the care they need, Coloradans tell me they are having trouble finding it. timely care. Congress needs to act urgently to improve access to mental, behavioral, and physical health care across the country. Our bipartisan bill will make it easier for Colorado seniors to find and see providers covered by their health plan.
Too often, Tillis said, North Carolinians, especially seniors enrolled in Medicare Advantage and those in need of mental health services, find themselves unable to access the care they need. they need because the supplier directory is incorrect. This law ensures that consumers can access up-to-date provider information, helping them make informed decisions about their health care.
When Americans buy and use their own health insurance, they have the right to know whether their doctor is covered by that plan, Wyden said. Often, seniors and families experience health care challenges when they sign up for a plan only to learn that their preferred doctor is out of network or cannot find a provider. Mental health care is covered. This bipartisan legislation is a big step toward holding insurance companies accountable to keep their provider lists accurate, and I will work hard to get it passed.
Many seniors enrolled in Medicare Advantage rely on their health plan’s provider directory to find in-network physicians and physicians, but inaccurate data can make finding a provider difficult more or lead to unexpected costs. These inaccurate provider directories are called ghost networks because some of the health care providers listed are not in the patient’s network, are not accepting new patients, or in some cases , is no longer active.
Ghost networks make it harder for patients to find in-network health care providers, a more pressing problem in the mental and behavioral health field, leading to unexpected costs or missed care. cause is delayed.
Specifically, the REAL Healthcare Providers Act would:
- Strengthen requirements for Medicare Advantage plans to maintain accurate and up-to-date provider directories;
- Ensure patients do not pay out-of-network charges for appointments with providers incorrectly listed in their plan’s provider directory as in-network; And
- Directs the Centers for Medicare and Medicaid to publish guidance on plans for maintaining accurate provider directories.
In the midst of a mental health and substance use crisis, people need to access the help they need easily and quickly. The federal government pays Medicare Advantage plans to provide timely services, but their inaccurate provider directories lead to frustration, financial hardship, delays and denials of care. MHA supports this bill as an important step forward in addressing this persistent problem that causes so much harm to people with mental health and substance use conditions and their families.
Inaccurate provider directories may sound harmless, but they prevent people from getting treatment or leave them with surprise bills for out-of-network care. Inseparable applauds Senators Bennet (D-CO) and Tillis (R-NC) for their bipartisan cooperation on this bill that will help protect people from those unfair charges, Founder and Inseparable President Bill Smith said.
The text of the bill is available HERE. A summary of the bill is available HERE.
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