Finance committee will come to order today across Insurance Companies are excelling Mental Health coverage to our people worried about their Mental Health or that their loved ones. Unfortunately too often after these insurers take big premiums from our people. They let them down. The providers they advertise arent available. They can get appointments. The firm basically says we arent taking new patients which of course we not represented to theminitially in that way. The fact is these americans are being off e by what the government accounting process as described as a goat network. Not my language, the of accountability. The, was a Ghost Network is all about is essentially selling Health Coverage under false pretenses. Because the providers who can advertise avarent picking up the phone. They arent seeing patients in business product or service doesnt meet expectations consumers get a refund. In my view is a breach of contract for Insurance Companies to sell their plans for thousands of dollars each month while there i is unusable. Unusable due to a Ghost Network. So im going to work with all my colleagues here on both sides track and get some real accountability for these patients who paid good money for Mental Health coverage tland they find there is very little there. And in the moment of National Crisis of Mental Health and with problem growing at such a rapid rate the existence of these Ghost Networks is unacceptable and somebody is worried about their Mental Health is our work up the courage to step up and try to coordinate their care if they cant get help , the last thing they need from the Insurance Company is a survey of these old music when a call. And nonworking numbers and rejection. We can all mention what were hearing from our constituents. I talked to all all my colleagues about this Mental Health challenge weve been working on it together. What ive described is notan owner. Staff conducted a secret shopper study. They made appointments with Mental Health providers. In 12 Medicare AdvantageInsurance Plans and results were clear. Our secret shoppers and this is after people had a vast sums t. They could get an appointment only 18 percent of the time. That means more than eight in 10 missile providers listed in these Insurance Company materials were inaccurate or taking appointments third of the time the phone number a day. Alled was oh one was connected to High School Health center. Senator cassidy is a real pro all this and i think both of us would probably laugh we feel like crying for the patients are representative of. In my home state im not proud of our investigators to my staff found we can make one successful other secret shopper studiesfound the same thing. Researchers ngseeking care for depression esand present time 18 pretty much the same result. Those networks are anongoing persistent problem. I actually start looking for redress on this issue on equity into improving dental health care for all and i look down the road darting with senator crepo on this because weve been working on this bipartisan basis we got plenty more to do to talk about our weekly conversations. Finally just looking at the Ghost Network issue to wrap up, we got to have more oversight, Greater Transparency and serious Insurance Company is losing american consumers. And i believe certainly Greater Transparency up to be an easy one for members of this committee to get around i dont know anything about the ability you get with transparency in nonpartisan issue i want to work with my colleagues on that issue, only constantly question i want to look at this cross lord not just with respect to medicare and medicaid then my colleagues expressed interest in applying policies to commercial interests sponsored plans will not be anything partisan and many of my friends will have a review. Thank you senator wyden is no secret to and you and i have prioritized mental en Health Delivery in america. The number of major initiatives through side of the law there are a number of major issues such as this one that we still have work to do i appreciate the opportunity to work with you on it. Last congress came together to dozens of bipartisan policies to expand access to Mental Health care services. These reforms will increase the number of providers and allow patients to receive care in a more convenient to location including rooftop. However in order for these approved improvements she patients need accurate and uptodate information. Ive long champion Medicare Advantage for its ability to offer patients choice and control over their healthcare through robust competition and innovative benefit offerings Medicare Advantage provides consumer focus healthcare coverage to millions of americans as enrollment continues to grow and accuracy and provider directories to strengthen Medicare Advantage. The patient provider relationship is the foundation of the health care system. Whether a patient is suffering from Mental Healthcare crisis were just received a troubling diagnosis directories should serve as crucial tools to help seniors across the country. While we were to better align incentives provider directory accuracy we must also do so without increasing burdensome requirements will only weaken our Mental Health workforce. Regulatory redtape and reimbursement strain can decrease patient access, exacerbating physicians shortages, compounding burnout and eroding Health Care Access and quality. Congress should build on her relief measures like the ones we advanced last year including temporary schedule support medicare telehealth expansion to address these issues of bipartisan and sustainableaces. Physicianpatient stabilization and Health Coverage for seniors received on support from members of both parties in both chambers. As we look to enhance medicare we should prioritize these and other bipartisan goals and we must do so in a fiscally responsible manner. I look forward to hearing from witnesses opportunities to streamline and improve provider reporting requirements , empower patients and ration and is moretransparent Healthcare Systems. Thank you senator and you wake up number of areas where we can continue our bipartisan cooperation is important to resuming it with you and your colleagues. Let me introduce ourwitnesses briefly. Our partnership is inseparable in partnerships working to improve Mental Health care and we welcome you and you are a leading alhealthcare advocate doctor jack resnick is here president of the medical association. I know youre a professor and chair of the Dermatology University of california San Francisco and i have been in healthcare discussions a number of times phd md comes to us with a recommendation on the American PsychiatricAssociation Organization at the forefront of Mental Health parity. We welcome you and you had a long relationship with the American Association married gilbert and served as chief Public Policy officer for Mental Health america and is also author of an important series looking at how these powerful special interests determine the quality and stability of solar Mental Health care in america and going have doctor jeff riddell president and ceo of integrated Healthcare Association be recognized for his work in provider Data Management. Thats a mouthful and plain old english makes sure theres a focus on only now where theres so much content on injuries presented in an intolerable way here lets begin with you. Thank you chair wyden, Ranking Member crepo. Thank you for conducting this hearing today and are testifying regarding those networks my name is caro Vice President inseparable, a nonprofit working to advance policy reflexively the health of our minds and our bodies is in several im also a Mental Health advocate and survivor with milived experience of Ghost Networks and health plans. Im your attention to this critical issue. Ghost networks present invisible eyesight barriers in our Health Systems for preventing peoplefrom accessing the support they need. They are particularly damaging those of us living serious Mental Health conditions itlike me as they can result in delay or in a or even going without any of which can be devastating and have devastating consequences First Experience with Ghost Networks i had to change Health Insurance due to an in 2014. Navigating a Blue Cross Blue Shield provider directory to find a psychiatrist in the dc or maryland turned into r. One rejection after another call after call resulted in the following types ofresponses. . She doesnt work you know where they are. I dont know that is not true they work here dies. Recorded message. Doctor fill in the blank is no longer accepting new patients. This is an emergency and 11 was days and hours during the finally found a psychiatrist taking new patients success though was shortlived call to set up an appointment i was asked about my diagnosis and i responded schizophrenia. I contacted my psychiatrist in california asked if and how remains. I like regularly to los angeles for over a fouryear period to ensure i could be instable. I paid high network copay but at least i have a provider on same plan turned out to be thyroid cancer, is able to find an endocrinologist the same day but for Mental Health is a different story, a story that continued throughout my career. 2018 began working for the Los Angeles County department of Mental Health l. A. Based psychiatrist now with my colleague along with another psychiatrist. I searched directory is received. Jpo2020 and 2022 i dont with Insurance Plans from a provider directory. Each time it felt like the movie groundhog day to provider here, no one butob me, they retire arent taking new patients unfortunately my story is not unique. I peers with the help no space based similar challenges regardless of that they are covered by medical, private insurance. He is by having Health Insurance otherwise considered excellent, i have no regular psychiatrist. This leaves me with ongoing anxiety about what happened if i should be more ongoing of experience interactions with system andstice involuntary hospitalization. I dont ever want to go, has an extrinsic and because i wasnt able to find a provider for my directory and get the help i needed to stay well. About this my thyroid condition, i have a specialist, ethnologist available under every Insurance Plan. I did not hang . Emergency care and get out of bed and later to find a provider covered by their insurance. Mean Providers Companies directories are almost useless, as a driver with the decant health plans, i urge the committee to act on this critical issue policies and i have three recommendations. Provide oversight enforcement and incentives necessary for highly inclusion of specialties andd directories implement federally operated mechanism only reporting dedicated 1800 number for consumers to report their experience is in use Information Support policies and inform policy and enforcement action. Thank you again for the opportunity to share my story today. Id bery happy to answer any questions you may have. Its clear youre going to get plenty of questions. Thank you for being here. Thank you for the invitation to participate in the hearing. The president of the American Association, practicing physician and chair of the university of california San Francisco. As you said physician provider directory is critically born tool they haveys patience select Insurance Products that cover positions part of the care team and in network care they need once covered. The first patient in representation in Network Adequacy regulators. Directory information is incorrect, results are sleek and devastating for patients youve heard. From her experience. A time when our nation is fighting the behavior of crisis, directories are not actually families already in great stress. Li they must waste time on practice after Practice Department network and accepting new patients. It masks the fact that insurers consistently and egregiously failed to provide adequate networks that comply with the laws causing harmk to millionsf americans. The problem is not. Not only have i read studiesan showing the local problems of directories but have conducted a study myself in this hearing addressed to me. A few years ago i met students called every dermatologist for every plant and it doesnt u. S. Metropolitan areas. Patients with severe rash and the results are dismal or thousand listening, almost half present a duplicate among remaining prisons, many didnt exist and have never heard of the physician reportedly died,d, retired or moved away. Others were not accepting new patients or the wrong specialty altogether. In the end, 27 and offered an appointment. More recent studies including your own, mr. Or chairman, demonstrate these problems persist or even worsening. Directory accuracy and i acknowledge physicians have a role to play but the responsibly of directly ultimately lies with the plan. Being listedf correctly is a component of a health plan contract. The plan for not making it easy for physicians to help i work Academic Medical Center our staff would equate to more accuracy complaints once to add or delete after we notify them of changes. Use standardized formats and different rosters formatting for each andrm everyone. G carcasses typically contract plans a costly demoralizing the term when the pandemic directly levels of burnout they think about the growing obstacles like errors positions. They need to spend time doing their called to do in the first place, taking great care of our patients water solution 21 corroborating to examine position directory here to arch all organizations regarding health plans an active role in reviewing and assessing actors and directors. For example regulars should require plans to submit accurate directories of your. Thats what patients deserve on a fauci, take enforcement action plans to maintain a directory of monetary penalty and encourage stakeholders to develop common standards forar updating directy and they dont have 20 different numbers and require plansns to remove physicians who no longer participate in the network. My city was in 2014 and here we are today. Enough is enough. We can fix this. I urge policymakers to continue issues forha inaccurate directories. Problems like overall Workforce Shortages, lack of adequate plans and here in Mental Health purity lost. Thank you for hearing my comments. Chairman whiting. On behalf of the American Psychiatric association, i want to thank you for conducting this hearing and all of us. We greatly appreciate continue bipartisan efforts topp confront myself Substance Abuse crisis in america. Refer the opportunity testimony today. Plans purchased by individuals andriha employers in public plas like medicaid and medicare my written testimony state of several studies about ubiquitous nature of directory inaccuracies. These include misrepresentation clinicians accept new patients, home phone numbers clinicians no longer in the state that i would like to speak about my personal how networks affect ourr patients. Providers increased costs. Mymy department is in rural virginia deliver 90000 care physicians year, individuals with a broad range of complex Mental Illness and Substance Abuse disorders. Access to care rural settings like my is particularly challenging generally required to travel hours to find psychiatric care. Finding anyone accepting new patients would be nearly