Error-filled directories leave thousands in Pa. unable to find health care providers

HARRISBURG — The information that thousands of Pennsylvanians rely on to find health care providers and schedule appointments is riddled with inaccuracies that often go months without being corrected, in violation of federal requirements, according to a study commissioned by the state Insurance Department.

Insurance companies are required by law to publish up-to-date lists of health care providers in their networks. But the study, based on surveys of more than 7,700 providers across all eight companies that sell insurance plans through the state’s Affordable Care Act marketplace, found widespread inaccuracies in those listings.

A record 490,000 Pennsylvanians bought insurance coverage through the state’s ACA marketplace, Pennie, during the open enrollment period for 2025, according to the Insurance Department.

Flawed directory information often went unaddressed for months, the study found — despite a federal law that requires insurance companies to update provider listings every 90 days at minimum. The law also requires insurers to purge from their directories providers whose information they cannot verify. The state Insurance Department is responsible for enforcing the law in Pennsylvania.





https://www.spotlightpa.org/news/2025/02/pennsylvania-insurance-provider-directory-errors/