a lower-stress (lower-stakes?) political post

[redbird]

A few days ago, cattitude mentioned something he'd seen on Twitter, about a health insurance tactic to stop people from getting mental health care: listing non-existent psychiatrists in their networks so the would-be patient would be frustrated and give up without ever finding care the insurer would have to pay for. (He mentioned this because I'd spent an annoying amount of time in April and May trying to find a psychiatrist.)

There's a proposed bill in Massachusetts, H.913, which would outlaw this bit of fraud; the legislature's website says both my (generally excellent) legislators are co-sponsoring it. I sent a quick email thank-you to both, and got an answer from Denise Provost, saying "I know that Somerville residents are deeply engaged in the public policy issues of the day, but the range and depth of community concerns is always a marvel. Thanks for paying attention, and thanks for your advocacy."

(This post started as a comment on thisfinecrew.)

Comments

[the_rck]

Fifteen or so years ago, my husband's employer tried to force a switch to a different insurer, and when I looked at the providers in our town, there were only 2 MDs of any sort. The woman from HR tried to convince me that a specialist in pulmonary oncology would be a viable primary care physician.

For mental health coverage, we've had problems with Aetna pulling a fast one by telling clinicians that they're authorized and then going, "But not for that! You're just authorized to get informational email from us," when the clinician submits the bill.

[redbird]

Argh. I'm sorry you're dealing with that.

The closest I've come to that was finding that a doctor I'd just been to, in order to check whether I had heart problems, took patients for primary care as well as cardiology, but for me was only in-network as a specialist. (I'd become dissatisfied with my primary care doctor, mostly because I was having trouble getting appointments and had to call, sometimes more than once, for test results.)

[thnidu]

Sons of bitches! (With apologies to the female moiety of all canid species.)

[otter]

The bigger and whiter the crime, the harder it is to call people to account. Insurance companies are full of criminals, on par with the banking and pharmaceutical industries. Thank you for your political activism. May it do us all some good.

[vass]

Holy shit. That makes me wonder if the NDIS is doing that here. Not for psychiatrists necessarily, but other kinds of disability service providers. I suspect they wouldn't need to, unfortunately: all they'd need is not to vet the listings.

[redbird]

Not vetting the listings would produce directories that included listings for people who were lying about a degree or retired last year: not "this is a MacDonalds" or someone who retired 20 years ago.

[calimac]

That isn't already illegal?

[redbird]

I think this may be a case of active responsibility: right now it would be illegal for me to advertise for or accept patients while falsely claiming to be a psychiatrist or licensed social worker, but not for a health insurer to add my name and phone number--or a random name of someone else without that credential and my phone number--to their list of in-network psychiatrists.

Or it may be one of those things that now is technically illegal, and if someone is caught at it they pay a $10 fine and are being told not to do it again, like jurisdictions where the penalty for driving without a license is to have that non-existent license suspended. I haven't done a lot of research here, including not checking to see what enforcement mechanism or penalties are in the new bill, just followed the breadcrumbs as far as whether my legislators had cosponsored this.

The area I now live in seems to be reasonably well-supplied with internists and family practitioners, which is definitely a good thing, but less so with certain specialists, including psychiatry (M.D., there seem to be a reasonable number of non-M.D. therapists) and ophthalmology (again, people whose care only needs an optometrist have more choices).

[cjsmith]

Wow. That's... wow. Thank you for being engaged.

[minoanmiss]

Yeah, wow. And yes, thank you.

false info in provider listings

[bibliofile]

Yes, wow. Thanks for noticing and for passing on the word.