Anthem Blue Cross Facing Class Action Lawsuit in New York Over Alleged ‘Ghost Network’ of Mental Health Providers

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A proposed class action lawsuit claims Anthem Blue Cross entices new customers by publishing a so-called “ghost network,” a provider directory that contains “grossly inaccurate” listings of mental health professionals who are not actually in-network or available to see plan members.

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The 72-page lawsuit—filed in New York by two Federal Employees Health Benefits (FEHB) plan participants—alleges that a “vast majority” of the mental health providers published in Anthem’s directory are either unreachable by the phone number listed, closed to new patients or unable to take the defendant’s insurance. Per the case, Anthem’s ghost network sends patients on a “wild goose chase” searching for care, a frustrating experience that can prove detrimental to their mental health.

As the filing tells it, ghost networks are “replete with errors and duplications” and constitute a widespread issue, particularly in the mental health industry.  

“Because people in need are unable to find a mental health provider covered by their insurance on their plan’s provider directory, urgent mental health treatment is often delayed and, at worst, abandoned completely,” the case stresses.

Other patients have been forced to pay thousands out of pocket after settling for out-of-network treatment or receiving unexpected bills from providers they were led to believe were in-network, the complaint claims.

According to the suit, Anthem intentionally inflates its directory with “ghost” practitioners to attract potential customers. Federal employees, retirees and their families are given multiple health insurance plan options under the FEHB program, and Anthem “lures” participants into choosing one of its plans by publishing a “seemingly robust, if secretly inaccurate,” directory of participating providers in their area, the filing alleges.

What’s more, the lawsuit contends, the defendant uses its ghost network to appear compliant with state and federal laws that require health plans to maintain a network of providers sufficient to meet the needs of enrollees. The federal No Surprises Act and New York law also require health insurance companies to publish accurate, up-to-date provider directories, the filing says.

“Despite these legislative efforts to shield consumers from ghost networks, surprise bills, and inadequate in-network care, insurance companies in general, and the defendant in particular, continue to violate these laws,” the Anthem lawsuit charges.

The complaint shares that in March 2024, the plaintiffs’ counsel conducted a “secret shopper” survey using Anthem’s “Find a Doctor” online tool. As the filing tells it, the plaintiffs’ counsel searched for a psychiatrist within 10 miles of Yonkers, New York, and the tool generated 759 results that purportedly matched the requirements, were in-network and were at locations accepting new patients.

“These results were fundamentally wrong and misleading,” the suit says.

According to the case, the staff attempted to schedule in-network mental health appointments by contacting the first 100 listings. Out of those, they could only secure appointments with seven providers, the complaint relays.

“The rest of the listings were either not in network, not mental health providers, did not accept new patients, were not reachable, or could not get an appointment in less than six months,” the case contends.

The lawsuit looks to represent anyone who is currently, or was previously, enrolled in one of Anthem’s FEHB plans at any point in or after 2018 and attempted to utilize the company’s directory of mental health providers.

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