North Charlotte Today

Senators Thom Tillis, Ron Wyden, and Michael Bennet have introduced the bipartisan Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act to address the issue of inaccurate provider directories in Medicare Advantage plans. The bill aims to protect seniors from unexpected healthcare costs and ensure that consumers can access updated provider information.

According to Senator Tillis, inaccurate provider directories often prevent North Carolinians, especially seniors enrolled in Medicare Advantage and those in need of mental health services, from accessing the care they need. He emphasizes that this legislation will enable consumers to make informed decisions about their healthcare by ensuring accurate and updated provider information.

Many seniors enrolled in Medicare Advantage rely on their health plan's provider directory to find in-network physicians and practitioners. However, inaccurate data can make it difficult to locate a provider or result in unexpected costs. These inaccurate provider directories are referred to as "ghost networks" because they include healthcare providers who are not in a patient's network, not accepting new patients, or no longer in business. This issue is particularly challenging in the mental and behavioral health fields, leading to unexpected costs or delayed patient care.

The REAL Health Providers Act proposes several measures to address this problem. It aims to strengthen requirements for Medicare Advantage plans to maintain accurate and updated provider directories. Additionally, the bill ensures that patients do not incur out-of-network costs for appointments with providers incorrectly listed as in-network. The Centers for Medicare and Medicaid would also be directed to publish guidance for plans to maintain accurate provider directories.

Various organizations and individuals have expressed support for the bill. Mary Giliberti, Chief Public Policy Officer of Mental Health America (MHA), states that the bill is an important step forward in addressing the harm caused by inaccurate provider directories, particularly for people with mental health and substance use conditions. Bill Smith, Founder and President of Inseparable, applauds the bipartisan collaboration on this bill, as it will protect people from unfair charges resulting from inaccurate provider directories.

The text and summary of the bill are available for reference. This legislation aims to improve health care access and protect seniors from unexpected costs by ensuring that Medicare Advantage plans maintain accurate provider directories.

To learn more, click on this link: https://www.tillis.senate.gov/2023/10/tillis-colleagues-introduce-bill-to-improve-health-care-access-protect-seniors-from-unexpected-costs