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“I Don’t Want to Die”: Needing Mental Health Care, He Got Trapped in His Insurer’s Ghost Network (www.propublica.org)

submitted 2 months ago by [email protected] to c/news

27 comments fedilink hide all child comments

Ravi didn’t know it, but he, like millions of Americans, was trapped in a “ghost network.” As some of those people have discovered, the providers listed in an insurer’s network have either retired or died. Many other providers have stopped accepting insurance — often because the companies made it excessively difficult for them to do so. Some just aren’t taking new patients. Insurers are often slow to remove them from directories, if they do so at all. It adds up to a bait and switch by insurance companies that leads customers to believe there are more options for care than actually exist.

Ambetter’s parent company, Centene, has been accused numerous times of presiding over ghost networks. One of the 25 largest corporations in America, Centene brings in more revenue than Disney, FedEx or PepsiCo, but it is less known because its hundreds of subsidiaries use different names. In addition to insuring the largest number of marketplace customers, it’s the biggest player in Medicaid managed care and a giant in Medicare Advantage, insurance for seniors that’s offered by private companies instead of the federal government.

ProPublica reached out to Centene and the subsidiary that oversaw Ravi’s plan more than two dozen times and sent them both a detailed list of questions. None of their media representatives responded.

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[–] WoodScientist 33 points 2 months ago (1 children)

Insurance companies need to face financial penalties for having these ghost networks. You should legally be able to demand, and sue for, $50 for every fake listing you find in your insurance's company's network. This is the 21st century. It should be possible for insurance companies to instantly know whether providers are still accepting new patients. Insurance companies could have a platform where providers can instantly indicate that they're no longer accepting new patients. And insurance companies could add penalties to their contracts with providers. If the providers don't update their status as soon as they are no longer accepting new patients, then the providers themselves will have to pay some sort of penalty.

[–] [email protected] 8 points 2 months ago

I mean, I've been voting about forty years, been told to vote blue just once more since Bill Clinton, and people would burn me at the stake for finally realizing the illusion of choice/ratchet effect. I'm over it.