Wyden speaks with reporters Sept. 11. Photo: Drew Angerer/Getty Images
Senate Finance Chairman Ron Wyden is hoping to get a new bill cracking down on "ghost networks" in Medicare Advantage into an end-of-year package, he told Axios.
Why it matters: The effort is part of a push to improve access to care, especially for mental health, and make sure insurers' provider directories are up to date so that patients can actually find providers who are covered.
Driving the news: Wyden introduced the bill last week with Sen. Michael Bennet and, notably, a Republican, Sen. Thom Tillis.
- The bill strengthens requirements for MA plans to have up-to-date and accurate provider directories, and prevents patients from having to pay higher out-of-pocket costs if their insurer said a provider was in-network when it actually wasn't.
What they're saying: "I hope that we can make that part of the end-of-year package," Wyden said of the bill.
- Finance Ranking Member Mike Crapo is not currently a sponsor, but Wyden said "Sen. Crapo and I continue to have conversations," which he declined to detail.
Yes, but: Some Republicans, as well as health insurers, have raised concerns with the ghost network push before, as we reported regarding Wyden's bill with Sen. Tina Smith, which applies to employer-sponsored plans.
- It remains to be seen whether objections bubble up on this MA-focused push. America's Health Insurance Plans did not respond to a request for comment.
- Tillis has been active on mental health issues, helping launch a Senate mental health caucus this month.
- "Far too often, North Carolinians, especially seniors enrolled in Medicare Advantage and those in need of mental health services, find themselves unable to access the care they need due to inaccurate provider directories," he said in a statement.
The big picture: Aides and lobbyists say the Finance Committee could have a markup next month on mental health issues, including some provisions left over from the working groups the panel created last year.
- Asked about a markup, Wyden said: "We're working on some ideas and hope to be able to give you and the good people at Axios here some additional information, but I don't want to front-run Sen. Crapo, and we're working through that."
- He added that they are still working on "scoring issues" at CBO.
Of note: On another Medicare Advantage front, Wyden held a hearing last week on deceptive marketing practices by insurance broker "middlemen."
- Wyden told Axios he thinks regulations from the administration are the best way to deal with that issue. "My sense is that we're going to get the middlemen by rule fastest, and I've really made it clear that that's a priority of mine with CMS," he said.
