Many Medicare Advantage & Medicaid Managed Care Plans Have Limited Behavioral Health Provider Organization Networks, Inactive Providers

Many Medicare Advantage and Medicaid managed care plans in 2023 had limited behavioral health provider organization networks, a high percentage of inactive providers, and inaccurate contact information, according to a recent analysis by the Office of the Inspector General (OIG) for the federal Department of Health and Human Services (HHS). "Inactive providers are sometimes referred to as 'ghost' providers, and can make the networks appear larger than they are," the report stated.

The analysis defined inactive clinical professionals as those listed in directories, but who provided no services in 2023. For Medicare Advantage, an average of 55% of behavioral health . . .