Federal Report Finds ‘Ghost Networks’ Limiting Medicaid Maternity Care Access

A new federal report highlights Medicaid maternity care access challenges, including inaccurate provider directories. The WSMA is advocating for stronger oversight, improved maternal health access, and targeted investments to support obstetric care across Washington.

The Office of Inspector General recently released a new report on “ghost networks” for maternal services in Medicaid. The report analyzed the physician directories of three large Medicaid managed care organizations across five states, including Washington state. According to KFF, 35% of all births in our state are covered by Medicaid.

Of particular note, the report raises concerns regarding the inclusion of physicians listed in directories who were not actually in network, inaccurate contact information, and missing in-network physicians. Based on these findings, the OIG recommended that the Centers for Medicare and Medicaid Services should take steps to hold Medicaid MCOs accountable for the accuracy of their online directories.

Ensuring access to high-quality maternity health care services across the state is a priority for the WSMA, guided by numerous House of Delegates policies focused on maternal health. Most recently, the WSMA provided input on the state’s Rural Health Transformation Fund application and allocation of funds, advocating for targeted investments to support obstetrics recruitment and retention activities, among other recommendations. The WSMA also participates on the governor’s sexual and reproductive health care work group and engages with a coalition of reproductive health advocates such as the Washington Chapter of the American College of Obstetricians and Gynecologists and Planned Parenthood on legislative policy work.