The provider directories of Medicaid managed care plans often list maternal providers who do not accept Medicaid patients.

At the same time, many of those provider directories list incorrect contact information for their participating maternal health providers.

These are among the findings of the U.S. Department of Health and Human Services’ Office of the Inspector General.

In two new audit reports, the OIG found that a review of several of the largest Medicaid managed care plans in the country found that anywhere from four to 22 percent of the maternal care providers listed in their provider networks were not actually part of those provider networks.  Meanwhile, between 22 percent and 41 percent of the providers that were in their networks had inaccurate contact information in their listings.

This is a major challenge for expecting mothers at a time when Medicaid is paying for more than 40 percent of U.S. births and most of those Medicaid patients are enrolled in managed care plans.

This can pose a special challenge to community safety-net hospitals like those that participate in the Alliance of Safety-Net Hospitals because they serve more Medicaid patients than the typical American hospital.

Learn more about the problem of ghost networks of Medicaid maternal health care providers and its implications from the Fierce Healthcare story “OIG report raises red flags about maternal health ‘ghost networks’ in Medicaid managed care” and the two OIG reports:  “Inaccurate Medicaid Managed Care Provider Directories May Limit Enrollees’ Access to Maternal Health Care” and “Inaccurate Medicaid Managed Care Network Lists May Compromise State Oversight of Access to Maternal Health Care.”