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Insurance directory errors cause challenges for consumers


Source:  Health Policy Institute of Ohio


As consumers review their coverage and shop for 2017 insurance through the federal health law’s online marketplaces, many of the directories they are using are outdated and inaccurate (Source: “Insurers’ Flawed Directories Leave Patients Scrambling for In-Network Doctors,” New York Times, Dec. 3, 2016).

Some doctors in the directories are not accepting new patients and some are not participating in the network, say experts, brokers and consumers. Still other physicians in the directories, who are listed as “in-plan,” charge patients thousands of dollars extra per year in “concierge fees” to join their practices.

“There continue to be inaccuracy problems,” said Justin Giovannelli, a Georgetown University professor, who studies coverage under the health law. Flawed directories are “a real barrier to accessing the care and accessing the insurance consumers have purchased.”

Like the federal Health and Human Services Department, Ohio instituted new directory-accuracy rules this year for marketplace plans. But enforcing them is “consumer-driven,” said David Hopcraft, a spokesman for the Ohio Insurance Department. The state does not check the lists until consumers report inaccuracies, one doctor at a time

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