Create a statutory, audit‑grade standard for provider directories and an enforceable 'ghost‑network' metric: regulators would require insurers to certify contactability, appointment‑availability windows, prior‑year visit counts per listed clinician, and to publish automated audit logs. Violations would trigger administrative fines, corrective action plans, and a private right of action for harmed patients and mis‑listed clinicians.
— This turns a widespread, hard‑to‑see access problem into a concrete regulatory tool that protects mental‑health access, reduces surprise out‑of‑network spending, and holds insurers accountable for the directories that gate care.
Max Blau
2026.01.09
100% relevant
The ProPublica story: EmblemHealth allegedly maintained an inflated provider directory that left NYC employees unable to find in‑network therapists and harmed providers listed incorrectly — the lawsuit offers the concrete actor (EmblemHealth), victims (NYC employees), and mechanism (directory accuracy) that this audit idea targets.
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