Raced to hold Physician Health accountable in space for rural health areas. As which was not represented initially in this way. The fact is, these americans are being ripped off by what the government in office has described as a Ghost Network. Not my language, but the language of the Government Accountability office. To me, but a Ghost Network is all about is essentially selling Health Coverage under false pretenses. Because, the providers that have been advertise are not picking up the phones. There are not taking patients. In any other business, if a product or service does not meet expectations, consumers get a refund. In my view, it is a contractor breach. Insurance Companies Sell their plans for thousands of dollars each month, while their product is unusable. Unusable due to a Ghost Network. I am going to work with all my colleagues on both sides, democratic and republican, to get real accountability for these patients who paid good money for mental Health Coverage and find there is very little there. In a moment of National Crisis about Mental Health, at a problem growing at such a rapid rate, the Ghost Network is unacceptable. If someone is worried about their Mental Health or the Mental Health of a loved one, it is hard to work up the courage. Hard to work up the courage to step up and try to coordinate their care. If they cannot get help, the last thing they need from a Big Insurance Company is a symphony of please hold music when they call and nonworking numbers and rejection. We can all imagine because we are all hearing from our constituents. I am looking at my republican colleagues. I have talked to almost all of them personally about the Mental Health challenge, and we are working on it together. What i describe is not a hypothetical better matter. My constituents and i did a secret shopper and looked at 12 Medicare AdvantageInsurance Plans in 60. Our secret shoppers could get an appointment. This was after people had paid vast sums of money. They could get an appointment only 18 of the time. That means more than eight out of 10 Mental Health providers listed in the Insurance Company or curios were an accurate or not taking appointments assertively time, the phone number they called was a dead and. In one instance, a staff trying to reach a Health Provider was connected to a High School ResearchHealth Center. Cassidy is a real pro at all these Health Issues and both of us would say that we laugh when he really feel like crying for the patients. I think that is representative of it. In my home state, i am not proud of what our investigators found there. My staff did not find that we can make one successful opponent appointment. Other secret shopper studies looked and found the same thing in 2017, but researchers posing as pears seeking care for a child with depression. They got care about 70 of the time. Ghost networks are an ongoing persistent problem and financers are looking close at this issue. You put a lot of equity into developing red legislation to improve Mental Health care for all americans from telehealth to youth health. I can look down the road starting with my republican colleagues because we have been working on this in a bipartisan basis. We have plenty more to do. Looking at the Ghost Network issue, it is a three leggett approach. Or oversight, transparency, and serious concert answers for companies clicking on american consumers. Greater transparency ought to be an easy one for members of this community to get around. I want to work with my colleagues on this issue, on the accountability questions. I want to look at this across the board. Not just with respect to medicare, medicaid, and many of my colleagues who have expressed interest in providing testimony. There is not anything partisan about it. Let me yield to my friend. Thank you senator wyden. It is no secret that you and i have prioritized Mental Health liberty in america. We have a number of major initiatives through in the last congress. But there are a number of major issues like this one that we still have work to do. I appreciate the opportunity to work with you on it. Last time, we came together to enact dozens of bipartisan policies to expand access to Mental Health care service. These reforms will increase the number of providers dissipating in medicare and allow patients to read care in more convenient locations, including through telehealth. In order for these improvements to its youth and uptodate information on their health care options. I have long champions Medicare Advantage for its ability to offer patients choice and control over their health care. Through robust competition and innovative benefit offerings, Medicare Advantage provides consumer focus Health Coverage to millions of american. As enrollment continues to grow, including improving the accuracy could further strengthen Medicare Advantage. The patient provider relationship is the foundation of the Health Care System. Whether a patient is suffering a Mental Health crisis or just read a troubling diagnosis, directories should serve as a crucial tools to help seniors across the country. While we work to better align incentives to improve providerdirectory accuracy, you must also do so without including burdensome requirements that will only weaken our Mental Health workforce. Regulatory red tape and reimbursement strain, among others, can also decrease patient access, exacerbating physician shortages, compounding burnout, and eroding health care axes and quality. Congress should build on their targeted release painters like the ones we had last year, including to marie physician fee schedule supports, and medicare telehealth expansion, to address these on a bipartisan and sustainable basis. Position payment stabilization at teleHealth Coverage for seniors have received strong support for members of both parties in both chambers. As we look to enhance that a care, we should prioritize these and other bipartisan goals. You must do so in a fiscally responsible manner. I look forward to hearing from witnesses about opportunity to streamline and improve provider reporting requirements, empower patients, and to give them Accurate Information and advance more Transparent Health care system. Thank you. Thank you, senator crapo. You have listed a number of areas where we can continue bipartisan conversations with our colleagues. My Vice President , a partnership that is working to improve Mental Health care. We welcome you. I know that you are a leading Mental Health advocate and decking it. Dr. Jack resnick is here, a president of the american medical organization. It is seeing dr. Resnick. In mark professor in the department of german polity in San Francisco germatology in San Francisco. You come at the recommendation of the psychiatric organization and have been at the forefront of Mental Health parity. We welcome you dr. Trust men with a long relationship with American Psychiatric association. Mary gill liberty serves as chief Public Policy officer for Mental Health america and has also done a important blood series looking at how these powerful special interests determine the quality and accessibility of so much Mental Health care in america. Then, we are glad to have dr. Jeff riedel, president and ceo of the health care association. He is walking nice for his work in Data Management. That is a mouthful. In plain english, making sure there is a focus now, where there is so much content making sure it is presented in an incredible way. Glad you are here. Lets begin with you ms. Myrick. Thank you for conducting this hearing today and providing the honor of testifying regarding Ghost Network directories. I am Vice President of partnerships, from a nonprofit working to advance policy that reflects the belief the health of our mind and bodies is inseparable. I am also a Mental Health advocate and survivor with limited steering is of ghost that and health plans. I am here to share my story and bring attention. It is invisible affected systems within our Health System, preventing people from accessing the care they need. They are particularly damaging for those of us living with serious Mental Health conditions, like me, as they can result in delayed or inadequate treatment or even going without. Any of which can be devastating and have devastating consequences. My First Experience occurred when i had to change my Health Insurance due to a new position with the federal government in 2014. Navigating the Blue Cross Blue Shield provider directory to find a psychiatrist in the d. C. Or maryland area turned into one rejection after another. Call after call resulted in the following types of responses. Who . Hmm . She does not work here. I dont know who they are. I dont know who that is. I am not sure they ever worked here. Hold please, dialtone. Or a recorded message that the doctor is no longer accepting new patients, if this is an emergency, hang up and dial 911. I spent countless days and hours scouring the networks and finally found a psychiatrist that was taking new patients. The success was shortlived. In a call to set up an appointment, i was asked about my diagnosis never a responder without any hesitation, schizophrenia. A pause, a long silence, and then, i do not take patients with schizophrenia. I asked if they had suggestions or referrals to help me find a doctor who does it the answer is, check the provider directory. Going back to the directory was like looking for a needle in a haystack. Lots of hay, very few needles in snow that could stick together the needs of my freddy a. Finally, i contacted my psychiatrist in california and asked if and how he could remain my doctor. I and flying regularly to los angeles on my own expense for over a four year period to enshrine can be and they well. I also paid high outofnetwork copays but at least i had a provider. On the same fan, when i needed a doctor for what turned out to be by word cancer, i was able to find an endocrinologist the same day but for Mental Health, it was a different story that continued throughout my career. In 2018, i began working for the Los Angeles Department of Mental Health. I then had to find another psychologist. I searched the provider directory with trepidation and received jet and responses. In 2020 and 2022, i dealt with new Insurance Plans any directories. Each time felt like the groundhog day movie with the layer responses that there is no provider here, nobody by that name, they are retired or not taking new patients. Unfortunately, my story is not unique. Many of my peers with Mental Health diagnoses they similar challenges, regardless of whether they are covered by medicare, medicaid or private insurance. Even today, despite having Health Insurance that is otherwise considered excellent, have no ongoing psychologist which leads me to Ongoing Society about ongoing anxiety about what would happen if i cannot get the care in. I have had involuntary hospitalzations and do not ever want to go through that again because i am not able to find a provider through my health plans directory. And do not have to worry about this for my thyroid condition. I have a specialist readily available under everett Insurance Plan. Why do i not have the same for my Mental Health . Senator wyden, you said too often americans who need Affordable Health care hit a dead end when they try to find a provider that is covered by their insurance. Ghost networks means the list of Mental Health providers and insurance of Company Directories are almost useless. Never a truer word. As a consumer with lived experience of Ghost Networks, i urge the committee to act on issues through the policies. One, provide the oversight enforcement and initiatives necessary to and incentives necessary. Two, require subdirectories and specialties. Three, lament an online recording system or dedicated 1800 number for consumers to report their experiences of Ghost Networks and to use the information to enforce policy, and form policy, and enforcement actions. Thank you for the opportunity to share my story today. I would be happy to answer any questions you may have for me. It is clear that she will get plenty of questions. We thank you very much for being here. Thats go to dr. Resneck let us go to dr. Resneck. Inky for the opportunity to dissipate. I am a practicing physician and chair of the department of dermatology in San Francisco. Physician provided directories are clinically important tools. They help patients to shop for and elect Insurance Products that cover physicians already part of their health care team, and find in Network Coverage they need once they are covered. They serve as a representation of a planted Network Adequacy for regulators. When directory information is incorrect, results are costly and devastating for patients as you heard from ms. Myrick and her lived experience. In a time when our nation is fighting a mental and Behavioral Health crisis, and accurate directories are not only an infuriating barrier for patients and families already in great periods of stress you must waste time calling practice after practice to find when actually in network and accepting new patients, but they mask the fact and shores consistently and egregiously mask insurance consistently and egregiously. It causes harm to millions of americans. The problem is not limited to Mental Health. Not only have i read many studies showing the scope of problems with provider directories, i conducted one myself. This is of particular interest to me. If you years ago, i had been students call every dermatologist listed in directories for many of the largest Mental Health plans largest medicaid plans. The results were dismal. Of 4754 listings, almost half represented duplicates. Among the remaining, many practices did not exist, had never heard of the listed position, or reported they had died, retired, or moved away. Others were not accepting new patients or were in the wrong subspecialty. In the end, just 27 of listings were unique and offer an appointment. Sadly, more recent studies, including your own, demonstrate these problems persist and are maybe worsening. Achieving directory accuracy is not simple insight knowledge Physician Practices have a role to play. But the responsibility of directory accuracy ultimately lies with the plans being listed correctly in the directory as a fundamental component of a Physician Health care there contra health plan contract. I work at a big academic medical center. You would think are a big staff devoted to this work would equate to more accurate listings, but health plans typically take six to eight months to add or delete physicians after we notify them of changes. They do not use standardized formats so we have to send different rosters with different formatting to each and everyone. Big and small practices, with 20 or more plans, amounts to a costly and demoralizing administrative burden. It happens at a time when we are emerging from the pandemic with skyrocketing levels of burnout. Facing a web of growing and wasteful obstacles from these same health plans. Author often was like prior authorization. My physician colleagues need to be free to spend time doing what drew us to medicine in the first place. Taking great