Anthem Blue Cross Blue Shield of New York’s directory of doctors is thoroughly inaccurate and forces patients to seek costly out-of-network care and delay care, a class-action lawsuit alleges.
This network of New York doctors, which patients expect will accept their insurance plan, in most cases does not. Many patients sought mental health care but struggled to find a doctor within their network while contending with dozens of false options, also known as ghost networks.
The plaintiffs’ attorneys, with law firms Pollock Cohen and Walden Macht Haran & Williams, completed a secret shopper survey to see how extensive the problem is for patients. After calling the first 100 doctors on Anthem’s directory, only seven accepted insurance and could take new patients. Most would not accept the right insurance, were not mental health providers, refused to take new patients or simply could not be contacted, a news release explains.
A downloaded directory of psychiatrists generated 4,300 providers, but many listings were duplicated dozens of times with different addresses and telephone numbers, the lawsuit (PDF) explains.
“We knew ghost networks were a problem, but we had no idea it was this bad,” said Steve Cohen of Pollock Cohen, one of the lead attorneys representing the plaintiffs.
Ghost networks are rife with errors and duplicate listings and are more common in mental health provider directories than in other areas of care, the lawsuit explains. Failing to find a mental health provider after embarking on a “wild goose chase,” as the lawsuit explains, can intensify mental health woes and lead to even more expensive medical bills.
These findings reinforce secret shopper studies from the New York attorney general office and the U.S. Senate. The New York attorney general’s study revealed 86% of mental health providers listed on a health plan’s network were, effectively, ghosts. The Senate Finance Committee’s survey (PDF) contacted providers in six states. On average, 82% of the directory listings were ineffective. In Oregon, all providers contacted were ghost listings.
The lawsuit claims Anthem knowingly keeps its directory stocked with inaccurate listings to offer the illusion of a robust catalogue of mental health providers, as it competes against other health plans. The insurer may also be attempting to meet federal requirements. However, ghost networks are a violation of the No Surprises Act and the Mental Health Parity and Addiction Equity Act as well as New York insurance law.
“In sum, these are deceptive business practices on the part of the defendant,” the plaintiffs wrote.
Nearly 3 million people were dealing with a mental illness in New York in 2022, accounting for 19.5% of the state’s adults, according to the nonprofit Mental Health America.
Anthem Blue Cross Blue Shield of New York did not immediately respond to a request for comment. Owned by Elevance Health, it is one of the largest insurers in New York.
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