Inaccurate provider directories—often referred to as “ghost networks”—have become a growing issue in the healthcare industry, particularly in behavioral health provider directory accuracy. These directories misleadingly list providers as in-network when they are actually unavailable, out-of-network, or no longer accepting patients. This leads to unexpected, often shocking bills for patients and creates significant delays or barriers to accessing care. For providers, ghost networks result in missed opportunities to connect with patients in need. As mental health challenges rise nationwide, policymakers are increasingly focused on holding health plans accountable and ensuring consumers are protected.
Last week, U.S. Senators Tina Smith (D-Minnesota) and Ron Wyden (D-Oregon) introduced the Behavioral Health Network and Directory Improvement Act, a significant piece of legislation aimed at cracking down on ghost networks and improving the participation of behavioral health providers in health plan networks.
What Are Ghost Networks and Why Are They a Problem?
“Ghost networks” refer to health plan provider directories that inaccurately list behavioral health providers as available and in-network when they are not. This can happen for several reasons:
- Providers leave networks due to low reimbursement rates.
- Providers stop accepting new patients.
- Directories are not updated regularly or accurately.
- Geographic accessibility and appointment availability are not reflected properly.
For patients, this means calling multiple providers only to find none are accepting new patients or that the provider is out-of-network, resulting in surprise medical bills or denial of coverage. Behavioral health care is particularly vulnerable due to already limited provider availability and a nationwide mental health crisis.
Providers also suffer. When networks falsely list them, they may receive inquiries or referrals they cannot accommodate. At the same time, providers who want to join networks may find low reimbursement rates and poor contract terms discouraging. Improving behavioral health provider directory accuracy is therefore critical to addressing these challenges.
Key Provisions of the Behavioral Health Network and Directory Improvement Act
The new bill takes a multi-pronged approach to improve the accuracy of behavioral health provider directories and strengthen network adequacy standards:
Independent Audits for Accuracy and Transparency
The legislation mandates independent audits conducted both by federal agencies and health plans themselves to verify the accuracy of behavioral health provider directories. These audits will assess whether listed providers are truly in-network, accepting new patients, and geographically accessible.
Audit results will be published online in a user-friendly manner, giving consumers, providers, and regulators transparent insight into network quality and behavioral health provider directory accuracy.
Civil Monetary Penalties for Noncompliance
Health plans that fail to comply with network adequacy and directory accuracy standards risk significant civil monetary penalties enforced by the Department of Labor. These penalties serve as a strong incentive for plans to maintain up-to-date, truthful directories and improve behavioral health provider directory accuracy.
Higher Standards for Network Adequacy
The bill raises the bar for health plans by requiring them to consider:
- The ratio of behavioral health providers to enrolled patients,
- Waiting times for appointments,
- Geographic accessibility (how close providers are to patients),
- And whether the network meets the specific needs of patients seeking care.
This ensures health plans actively maintain robust, meaningful networks rather than minimal or misleading provider lists, helping to improve overall behavioral health provider directory accuracy.
Behavioral Health Parity in Reimbursement
One major reason behavioral health providers leave networks is low reimbursement rates compared to physical health services. To address this, the bill requires federal agencies to establish parity standards that ensure behavioral health provider reimbursements are on par with physical health providers.
This provision aims to increase in-network behavioral health provider participation by making health plans more financially competitive and attractive to providers, which in turn enhances behavioral health provider directory accuracy by keeping listings current and reliable.
Provider Responsibility to Maintain Accurate Information
Behavioral health providers themselves will be required to regularly update health plans with timely and accurate information about their network status and patient availability. This shared responsibility helps prevent directories from becoming outdated or misleading and reinforces behavioral health provider directory accuracy.
Consumer Protections and Education
To empower patients, the bill creates programs at state and tribal levels to educate consumers about their rights under mental health parity laws and how to identify and address ghost network issues.
It also requires health plans to notify enrollees if they may be eligible for a refund when they receive care from a provider incorrectly listed as in-network, providing financial protection for affected patients.
Why This Legislation Is Urgently Needed
The importance of addressing ghost networks cannot be overstated, especially amid a growing mental health crisis in the U.S. Senator Ron Wyden called ghost networks “essentially a fraudulent product” in the worst cases, pointing out how insurance companies continue selling plans that appear to cover behavioral health care but are practically useless when patients try to access treatment.
Senator Tina Smith also emphasized that despite existing laws requiring mental health coverage parity, insurers still find ways to dodge compliance and deny patients the care they need.
Mental health conditions affect millions of Americans, and the lack of accessible, affordable, and timely behavioral health care exacerbates personal suffering and strains families and communities. Ghost networks only deepen these barriers, contributing to delayed treatment, worsening health outcomes, and increased costs down the line.
Improving behavioral health provider directory accuracy is a vital step in overcoming these systemic challenges and ensuring patients get the care they deserve.
Legislative Momentum and Broader Efforts
The Behavioral Health Network and Directory Improvement Act builds on previous legislative efforts targeting ghost networks. For example, the Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, introduced in October 2023, focuses on Medicare Advantage plans to ensure their provider directories remain up-to-date, protecting seniors from similar issues.
The new bill has garnered support from major advocacy groups including the National Alliance on Mental Illness (NAMI), The Kennedy Forum, and the National Council for Mental Wellbeing, signaling strong backing from the mental health community.
What This Means for Patients and Providers
If passed, the Behavioral Health Network and Directory Improvement Act could transform how behavioral health provider directories are managed, making it easier for patients to find the care they need without the fear of hidden costs or empty phone lines.
Providers would benefit from fairer reimbursement practices and clearer communication expectations, potentially increasing their willingness to join and stay in networks.
Health plans would be held accountable with stricter oversight and penalties, pushing the industry toward greater transparency and fairness — all helping to improve behavioral health provider directory accuracy across the board.
Conclusion
Ghost networks represent a critical, yet often overlooked, barrier to accessing behavioral health care. By tackling inaccurate provider directories, establishing stronger network adequacy standards, and promoting reimbursement parity, the Behavioral Health Network and Directory Improvement Act addresses key pain points for patients and providers alike.
As mental health challenges continue to escalate, legislation like this offers hope for a future where insurance coverage truly supports timely, accessible, and affordable behavioral health treatment.
Patients, providers, and advocates should stay informed about this bill and support efforts that prioritize transparency, accountability, and mental health parity. Improved behavioral health provider directory accuracy is essential for ensuring equitable access to mental health care.
If you or someone you know has been affected by inaccurate provider directories or difficulty accessing behavioral health care, consider reaching out to advocacy organizations or your elected representatives to share your experience. Together, we can push for policies that make behavioral health care more accessible and equitable for all.
