Illinois State Medical Society Statement on Insurance Co. “Ghost Networks”

Attributable to Regan Thomas, M.D., President, Illinois State Medical Society

The doctors of Illinois are concerned about recent reports of “ghost networks” perpetrated by state-regulated private health plans in Illinois. Insurance company provider directories often list doctors who are unavailable, not taking new patients, are located far away or who don’t work at the listed medical facility. This isn’t happening in just one part of Illinois, it’s a statewide problem.

We call on the Illinois Department of Insurance to enhance its enforcement of the ISMS-initiated Network Adequacy and Transparency Act, signed into law in 2017, including putting forth strict enforcement guidelines and penalties for non-compliance. This law provides important protections for patients, including continuity of care for those with ongoing and urgent medical care needs, such as cancer patients and expectant mothers.

ISMS also strongly calls for the insurance companies do a better job of keeping their published physician network information up-to-date as required by law. The inattention to this important task is impeding access to and continuity of healthcare, as well as the patient-physician relationship.

Illinois doctors urge patients to file complaints with the Illinois Department of Insurance whenever they experience these ghost network issues. Complaints can be filed online at https://www2.illinois.gov/sites/Insurance/Consumers/Pages/File-a-complaint.aspx.

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Founded in 1840, ISMS is a professional membership association representing Illinois physicians in all medical specialties, and their patients, statewide. Dr. Thomas is a practicing reconstructive plastic surgeon in Chicago.