A bipartisan group of U.S. senators is drawing attention to a growing and concerning problem in the health insurance industry: mental health ghost networks. These networks, which provide inaccurate or outdated lists of in-network providers, are creating significant barriers for patients trying to access mental health care.
Mental health ghost networks often list providers who are no longer in-network, no longer accepting patients, or whose practices have closed. For patients, this can lead to wasted time, confusion, and even financial burden when they end up paying out-of-pocket for care that should have been covered by insurance.
“Ghost networks sow confusion and frustration among patients who are often in need of immediate care,” the senators wrote. “Patients who lack the time and resources to sift through inaccurate provider directories may ultimately choose to forgo or delay needed health care. Others may be forced to pay out-of-pocket for a provider.”
Major Payers Under Scrutiny
The letters, penned by Senators Tina Smith (D-Minn.), Ben Ray Luján (D-N.M.), and Steve Daines (R-Mont.), were addressed to Aetna, Anthem Blue Cross Blue Shield, Humana, and United Healthcare. While mental health ghost networks are an issue across healthcare broadly, the senators highlighted that they are particularly widespread in behavioral health.
This issue is not just an inconvenience—it can have serious implications for patient care. Mental health conditions often require timely interventions, and delays in care due to mental health ghost networks can exacerbate symptoms, reduce treatment effectiveness, and even contribute to crises.
The senators emphasized that insurance companies are legally required to comply with the Consolidated Appropriations Act (CAA) of 2021, a law designed to protect consumers against surprise bills and improve transparency in healthcare. Yet, despite these protections, mental health ghost networks persist, particularly for Medicaid beneficiaries.
The Scope of the Problem
Recent research highlights just how pervasive mental health ghost networks have become. Over the summer, Health Affairs published a study examining Oregon’s Medicaid directories. The study found that 67.4% of mental health prescribers and 59% of mental health non-prescribers listed in the directory were phantom providers—clinicians who were unavailable or incorrectly listed as in-network.
These findings reveal a stark reality: patients seeking mental health care may face systemic obstacles before they even schedule an appointment. Mental health ghost networks contribute to delayed treatment, increased frustration, and additional financial strain, undermining the very purpose of insurance networks, which are intended to make care more accessible and affordable.
Legislative Efforts to Combat Ghost Networks
In response to this problem, lawmakers are pushing for stronger accountability measures. In November, Senators Smith and Ron Wyden (D-Ore.) introduced the Behavioral Health Network and Directory Improvement Act, a piece of legislation aimed at improving the accuracy of provider directories and expanding mental health network participation.
The bill focuses on several key areas:
- Strengthening directory accuracy standards to ensure patients can trust that listed providers are available and in-network
- Holding health plans accountable for inaccurate or outdated listings
- Boosting provider network participation to expand access to mental health services
“By law, insurance companies must cover mental health just like they cover physical health, yet they’re still finding ways to dodge compliance and deny coverage,” Senator Smith said. “By setting stricter standards and holding insurance companies accountable for inaccurate listings, this legislation will help ensure people can access the mental health care coverage they are entitled to.”
Why Accurate Directories Matter
Accurate provider directories are more than just a convenience—they are a matter of patient safety and access. Mental health conditions often require immediate and ongoing care, and delays in treatment can worsen outcomes. For patients, mental health ghost networks can mean:
- Hours spent contacting providers who are no longer available
- Frustration and confusion navigating insurance coverage
- Unnecessary out-of-pocket expenses when forced to see an out-of-network provider
- Reduced likelihood of following through with care, especially for low-income or time-constrained patients
By improving transparency and accuracy, lawmakers hope to make mental health care more accessible, equitable, and effective.
Moving Forward
The push against mental health ghost networks reflects a broader effort to ensure that insurance coverage meets its promise—especially for mental health. As lawmakers hold payers accountable and introduce new legislation, patients and providers alike stand to benefit from more reliable, transparent, and functional networks.
For patients seeking care, the hope is that these efforts will translate into real-world improvements: quicker access to in-network providers, less confusion, and better outcomes for mental health conditions. Accurate, dependable provider directories are a foundational step toward ensuring that mental health care is treated with the same priority, accessibility, and accountability as physical health care.
