Audit Ghost Networks

Updated: 2026.01.09 20D ago 1 sources
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.

Sources

They Couldn’t Access Mental Health Care When They Needed It. Now They’re Suing Their Insurer.
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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