Families often report that they have tried to locate an in-network psychiatrist from directories provided by their insurer, only to find that most of the providers listed are not available for a variety of reasons. This experience is not unusual. In the 2016 Maryland legislative session, bills were passed to help address this problem.
Background: In June of 2014 the Mental Health Association of Maryland performed a study to assess the accuracy and adequacy of the psychiatric networks of the 2014 Qualified Health Plans sold through the Maryland Health Connection. The study found that only 14% of the 1154 psychiatrists listed were accepting new patients and available for an appointment within 45 days. Fifty-seven percent (57%) of the psychiatrists were unreachable - many because of nonworking phone numbers or because the doctor no longer practiced at the listed location.
About the legislation: Senate Bill 929 and House Bill 1318 contain a number of provisions, including requiring the Maryland Insurance Administration (MIA) to develop network adequacy regulations for insurers, and enabling MIA to hold insurers accountable for maintaining accurate provider directories. Additionally, insurers must provide information on how members may seek an out-of-network referral when their network is inadequate. The bill measures will be implemented over time.
What you can do: If you are seeking behavioral health services and find that your insurer's provider network directory is inaccurate, or if you feel that you cannot access an in-network provider within a reasonable distance or time, contact Adrienne Ellis with the Maryland Parity Project at the Mental Health Association of Maryland, at firstname.lastname@example.org, 443-901-1550 x206.