Tag: Medicaid

Is “Ghost Networks” Lawsuit Against Insurance Companies the Failure of Mental Health Parity?

Written by Sheila Matthews on November 6, 2024. Posted in Articles.

November 7, 2024

It is of interest that a class action lawsuit has been filed in New York which alleges that insurance companies are deliberately harming patients because the directories of listed physicians and professionals are non-existent, a proverbial “ghost network.” The suit further alleges that “there is a mental health crisis in this country and in this state” and the provider directory, the “ghost network,” is “exacerbating patients’ mental health problems” because they can’t contact providers for services needed.

While there are many issues that AbleChild could address about this lawsuit, two problems come to mind. First, whether there is a “mental health crisis,” and who is responsible, is up for debate and, secondly, it seems to AbleChild that this lawsuit is simply an end-around to obtain increased pay for mental health providers, which is being addressed in many states’ Medicaid oversight boards and commissions.

First, the suit alleges that the insurance companies have “mislead” patients by “publishing grossly inaccurate directories of doctors and therapists.” The suit further alleges that these “grossly inaccurate directories” list doctors and qualified professionals who are not within the insurance network – “Ghost Networks.” These “Ghost Networks” “that are replete with errors and duplications, which make them inaccurate, incomplete, deceptive, and misleading” are more likely to be found in Mental Health provider directories.

Connecticut’s Mental Health Providers Beg for Increase in Medicaid, Despite Millions Spent & No One is Getting Better

Written by Sheila Matthews on September 15, 2024. Posted in Articles.

September 16, 2024

Summary Psychiatric Drug Use in Medicaid Population in Connecticut

Health care spending in the U.S. makes up 16.6% of the nation’s GDP, more than any other country in the world and mental health accounts for a reported 5% of that spending. Make no mistake, mental illness in America is an extremely costly or profitable health care problem depending on who is paying, and who is getting paid, for treatment services. What is also clear is that the numbers of Americans being diagnosed as mentally ill continually increases. At some point the question becomes with the hundreds-of-billions of dollars being dumped on mental health “treatment,” why isn’t anyone getting better?

In fact, as of April, the U.S. reports that one in five adults and up to 20% of children experience a mental illness with a price tag of an estimated $282 billion annually. The mental health “providers,” those non-profit organizations that states contract with to provide the needed mental health “treatment” services, complain that reimbursement for services is wholly inadequate. Maybe, but how do these behavioral health providers work?