[Alliance Enews] Governor Hochul, AG James Push Commercial Insurance Provider Network Improvements

[Luke Sikinyi]

Alliance Note: A major initiative outlined in Governor Hochul's proposed 2024-25 budget for New York is improving commercial insurance parity. One area of major concern for commercial plans is the outdated and insufficient provider directories. The NY Attorney General recently released a report<https://ag.ny.gov/sites/default/files/reports/mental-health-report_0.pdf> showing that 86% of the listed in-network providers either did not have accurate contact information or were no longer accepting new clients.
Accurate and adequate provider information is crucial to increasing access to support services for people on commercial insurance. People should not have to struggle to search for providers who accept their insurance while trying to address their mental health challenges. We must also ensure insurance companies provide sufficient reimbursement for services so people utilizing the services do not have to pay extremely high out of pocket costs. We are thankful to Governor Hochul for including a provision to force commercial plans to pay at least the Medicaid rate for services, which lower costs for people using services and better compensate providers who want to offer services to more people. See below for more information.

NY AG: Insurance Companies Need to Update Mental Health Provider Directories
By Jamie DeLine | Rochester First | January 15, 2024
ALBANY, N.Y. (WTEN)-One of Governor Kathy Hochul's top priorities for this year is to focus on the issue of mental health. She wants to make sure New Yorkers are getting the help they need through their insurance companies.
"One would say, I have insurance. Isn't that supposed to cover everything? Guess what. They have not been doing this," said Hochul. "Insurance companies, many are doing the right thing and there are others who are not."
A report released last month by the New York Attorney General's office found a majority of insurance companies had wrong information in their mental health provider directories.
https://ag.ny.gov/sites/default/files/reports/mental-health-report_0.pdf
"Their numbers were incorrect, they did not provide service, they only provided service that was virtual, they did not provide pediatric service, geriatric service, they could not be reached, they were no longer excepting new patients, or they did not even exist," explained Letitia James, New York's Attorney General.
James said those who need help should be able to get immediate assistance. To fix this problem, her office released recommendations to insurance companies.
"That their list be up to date, that they also create more incentives for providers to join their networks," said James. "Individuals should not have to go out of network and pay out of pocket for these services."
The president of the New York Health Plan Association said health plans work hard to ensure their directories are up-to- date and accurate.
Eric Linzer, President & CEO stated, "Our industry remains committed to working with the Attorney General, the Hochul Administration, and legislative leaders on policy solutions to increase access and ensure patients can get the mental health care services, care, and support they need."
NY AG: Insurance companies need to update mental health provider directories (rochesterfirst.com)<https://www.rochesterfirst.com/new-york-state/ny-ag-insurance-companies-need-to-update-mental-health-provider-directories/>


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