Nearly half of all Medicare Advantage provider directories contain at least one inaccuracy—and for seniors seeking behavioral health services, these errors can have serious consequences. From listing providers who are no longer in-network to those who’ve stopped accepting new patients or even closed their practices, these flawed directories are part of a growing problem known as “ghost networks.”
Now, a bipartisan group of U.S. senators is stepping in with proposed legislation that aims to clean up the mess. If passed, the Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act would require Medicare Advantage (MA) plans to keep their provider directories up to date, protect patients from surprise bills, and potentially strengthen provider networks across the board. This could mean more business opportunities for behavioral health providers and, more importantly, better access to care for seniors.
The Problem with Ghost Networks in Medicare Advantage
Ghost networks occur when provider directories are filled with names of doctors or specialists who aren’t actually available. These errors create major roadblocks for people looking for timely, covered care—especially in behavioral health. One Oregon study revealed that more than half of mental health providers listed on Medicaid managed care networks weren’t actually seeing patients.
For those relying on Medicare Advantage provider directories, these inaccuracies can waste precious time, lead to financial hardship, and delay or prevent care altogether. In fact, a study found that patients using inaccurate provider directories were four times more likely to receive an unexpected out-of-network bill.
The REAL Health Providers Act: What It Proposes
Introduced by Senators Michael Bennet (D-Colo.), Thom Tillis (R-N.C.), and Ron Wyden (D-Ore.), the REAL Health Providers Act takes direct aim at ghost networks by:
- Requiring Medicare Advantage provider directories to be updated regularly
- Mandating CMS (Centers for Medicare & Medicaid Services) to issue guidance on directory accuracy starting in 2026
- Protecting patients from being financially responsible when they rely on inaccurate listings
- Holding MA plans accountable for the accessibility and transparency of their networks
Senator Wyden summarized the frustration many face: “Too often, seniors and families get health care whiplash when they sign up for a plan only to find out that their preferred doctor is out-of-network, or it’s impossible to find a covered mental health care provider.”
By focusing on Medicare Advantage provider directories, the bill takes a foundational step in ensuring beneficiaries can actually use the care they’re promised.
Why This Matters for Behavioral Health Providers
Improving the accuracy of Medicare Advantage provider directories doesn’t just benefit patients—it also strengthens the entire behavioral health system. Today, countless mental health and substance use treatment providers go underutilized simply because MA directories are outdated or misleading.
By cleaning up ghost networks, MA plans may be forced to either expand or clarify their networks—opening the door for legitimate behavioral health providers to become more integrated into these systems. That could translate into stronger referral pipelines, more covered patient visits, and improved financial stability for practices offering vital mental health services.
Mary Giliberti, Chief Public Policy Officer at Mental Health America, emphasized this ripple effect: “The federal government pays Medicare Advantage plans to provide timely services, but their inaccurate provider directories lead to frustration, financial hardship, delay, and denial of care.”
The Road Ahead: A Legislative Battle Worth Watching
The REAL Health Providers Act was officially introduced on October 17 and referred to the Senate Committee on Finance. While no immediate action has been taken, its bipartisan backing makes it a strong contender to move forward later this year or early next—barring delays caused by broader federal budget discussions.
As the Senate continues to examine ghost networks—an issue highlighted in recent Senate Finance Committee hearings—momentum appears to be building. Advocates for behavioral health access and transparency in Medicare Advantage provider directories are watching closely.
Final Thoughts: A Win-Win for Patients and Providers
Inaccurate Medicare Advantage provider directories aren’t just an inconvenience—they’re a barrier to care, a drain on resources, and a source of stress for millions of Americans. For older adults managing mental health conditions, the stakes are even higher.
If passed, the REAL Health Providers Act could not only protect patients from ghost networks and out-of-network bills but also help behavioral health providers reach the populations they’re best equipped to serve. That’s a rare legislative win-win—and one that deserves attention and support.
