In 2023, Senate Finance Committee staff played secret shopper. They pulled mental health providers from the directories of 12 Medicare Advantage plans across six states and made 120 calls, ten per plan. They booked an appointment 18 percent of the time. More than eight in ten of the listed providers were unreachable, wrong, or not taking patients. A third of the numbers were simply inaccurate or dead. In Oregon, the staff got zero appointments.
Picture opening your plan's directory, calling ten therapists, and reaching fewer than two who can actually see you. That is the directory working as advertised on paper and failing the only test that counts: the phone call. New York's attorney general ran the same play later that year and found 86 percent of listed providers were ghosts.
A directory nobody is paid to keep accurate decays into a list of names, and the network looks full long after the providers have left it.