ACA network regulatory filings are inaccurate, poorly match provider directories.

ABSTRACT:

Objectives

Access to mental health services has been shown to be particularly inadequate, with limited understanding of the efficacy of existing network adequacy regulations. State and federal regulations mandate insurance carriers to submit regulatory filings to help maintain network adequacy compliance, but the accuracy of these data remains unassessed.

Study design

We employed a secret shopper survey to verify regulatory filings and assess the congruence between the filings and provider directory listings as well as appointment availability and wait time for 8306 mental health counselors submitted by all carriers participating in Pennsylvania's Affordable Care Act (ACA) Marketplace for plan year 2024.

Methods

Descriptive analyses, with tests of proportion and t tes

SUBMITTER: Haeder SF 

PROVIDER: S-EPMC12707803 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature