Oklahoma advances legislation to address ‘ghost networks’ of mental health providers
Two bills recently signed into law greatly enhance the ability of Oklahomans to access mental health care. Oklahoma Senate Bills 442 and 254 address high patient costs and excessive wait times for appointments by ensuring more transparency from commercial health insurance plans and capping out-of-pocket costs when a timely appointment with an in-network provider isn’t available.
The bills address key findings of Healthy Minds Policy Initiative’s 2023 research report on Oklahoma private insurance plans’ coverage of behavioral health services. Healthy Minds found that most behavioral health providers listed on health plan directories can’t be reached, aren’t actually in-network, or can’t schedule an appointment in a timely manner. Though many plans may appear robust on paper, the lack of in-network behavioral health providers is masked when insurance companies include incorrect or out-of-date information in their directories of plan-approved providers. These “ghost networks” commonly force patients to wait months for care, incur higher costs to see an out-of-network provider, or go without care altogether.
“The proliferation of ghost networks is one of the most persistent barriers to accessible, affordable mental health care for the more than 2 million Oklahomans with commercial health insurance. Mental health is a unifying issue in our state – roughly 50% of Oklahomans have experienced a mental health issue during the past few years. We commend our legislators for championing meaningful reforms that strengthen parity between mental and physical health care.”
Zack Stoycoff, Healthy Minds executive director
Even when Oklahomans can find an in-network provider, long wait times often discourage seeking care or delay life-saving treatment. When Healthy Minds called a sample of providers listed in Oklahoma insurance plan directories, only 18% who were able to be reached and agreed to an interview could schedule an appointment within seven days.
Senate Bill 254, authored by Sen. Jessica Garvin (R-Duncan) and Rep. Jeff Boatman (R-Tulsa), ensures that Oklahomans can still access mental health care even if they cannot find timely care from an in-network provider. The bill mandates that insurance companies arrange out-of-network care with costs for the insured capped at their in-network rates.
“In a mental health crisis, getting proper care can be a matter of life and death,” said Sen. Jessica Garvin. “This reform will make sure Oklahomans can get the help they need quickly and without the higher costs associated with out-of-network services, positioning our state to be a leader in increasing access to mental health care.”
In addition to timely access, inaccurate information is a significant burden facing Oklahomans in need. When Healthy Minds called a sample of 159 providers listed in the directories of major Oklahoma insurance plans, 103 were unable to be reached, and half of those had a disconnected or out-of-service phone line.
Senate Bill 442, authored by Sen. John Michael Montgomery (R-Lawton) and Rep. Chris Sneed (R-Fort Gibson), requires insurers to update information in their provider directories every 60 days. Directories must be available electronically in a standardized, searchable format. Additionally, the bill requires insurance companies to remove any provider from a plan directory if the provider has not submitted a claim to the plan within a 12-month period.
“Consumers rightly expect that information about their insurance plans is accurate, up-to-date and easy to find,” said Sen. Montgomery. “This bill will simplify the process of seeking in-network care and ensure more Oklahomans find treatment when they need it.”
A recent hearing of the U.S. Senate Finance Committee brought national attention to the prevalence of ghost networks. Despite bipartisan support for addressing the issue, Congress has not intervened. In contrast, Oklahoma legislators advanced groundbreaking legislation during their 2023 session to address the issue with near-unanimous support.
“Healthy Minds provided the Legislature with solid data and invaluable insights to address an all-too-common problem: Oklahomans are often unable to get the mental health care they need. We worked with stakeholders on both sides of this issue to find win-win solutions. I’m thankful to my colleagues in the Legislature who continued to prioritize mental health as a key issue this session.”
Rep. Jeff Boatman, co-chair of the Oklahoma Legislative Mental Health Caucus