Anthem Class Action Lawsuit: "Ghost Network" of Mental Health Providers Alleged

Case Overview: A class action lawsuit has been filed against Anthem, alleging the company misleads patients with a "ghost network" of inactive and nonexistent mental health providers in its directory, obstructing access to care and violating the No Surprises Act.

Consumers Affected: Individuals enrolled in Anthem's FEHP plans from 2018 who attempted to use Anthem's directory of mental health providers.

Court: U.S. District Court for the Southern District of New York

Health insurer Anthem is at the center of a lawsuit over claims it misleads mental health patients by listing inactive or nonexistent providers as "in-network" in its directories, leaving patients struggling to access much-needed mental health care. 

This alleged “ghost network” of fake or inactive providers has reportedly exacerbated a national mental health crisis by obstructing access to qualified providers and forcing patients to turn to costly out-of-network options, according to the lawsuit.

Anthem Lawsuit: "Ghost Network" of Mental Health Providers Harms Patients

New York residents Jane Doe and Patricia Cavallaro-Kearins filed the proposed class action lawsuit, with Doe saying she was representing both herself and her child. Both said they had experienced firsthand the impact of Anthem’s allegedly inaccurate directories after seeking mental health care for themselves and their families, only to find that Anthem’s listed providers were often unreachable, out of network, or no longer practicing.

The pair say they have faced wasted time, frustration, and significant out-of-pocket costs after relying on Anthem’s provider directory. Anthem members, often desperate for mental health support, report spending hours trying to contact listed providers, only to find that most numbers were wrong or that the providers had stopped accepting Anthem insurance or new patients, the lawsuit claims. 

In some cases, they’ve had to pay thousands of dollars to out-of-network providers when no in-network alternatives were available within a reasonable distance. For many, the issue has worsened their mental health, the lawsuit alleges.

Inaccurate Provider Directories Exacerbate Mental Health Crisis, Lawsuit Claims

The mental health crisis in the U.S. has left millions seeking care amid high provider demand, the lawsuit explains, and Anthem’s alleged “ghost network” only compounds this issue. Studies show that over 22 percent of U.S. adults are affected by mental illness, with a similar crisis in children’s mental health access. 

Anthem’s inaccurate listings reportedly lead patients down dead ends, where mental health care remains out of reach despite rising demand and financial struggles, particularly for low-income or minority families.

The lawsuit underscores that the time spent navigating incorrect listings can discourage patients from continuing their search for care. As a result, some abandon treatment altogether, risking severe outcomes like worsening symptoms or complications. For those continuing the search, incorrect listings often lead to financial and emotional stress, exacerbating existing mental health challenges.

Anthem Accused of Violating No Surprises Act with Misleading Provider Listings

Anthem allegedly knew that its inaccurate listings could violate the federal No Surprises Act, passed in 2022, which requires health insurers to maintain accurate provider directories. Under the law, insurers must verify provider details regularly, update directories within days of receiving corrections, and ensure that patients relying on inaccurate information are not overcharged for out-of-network care. 

New York state’s stricter law requires updates within 15 days for any provider changes, underscoring the state’s commitment to consumer protections.

Despite these regulations, Anthem has allegedly allowed outdated and incorrect information to persist, leading the two women to claim Anthem knowingly lured customers by exaggerating its network. By making its plans appear more comprehensive, the lawsuit argues, Anthem falsely suggested that patients would find an adequate network of in-network mental health professionals.

Growing Number of Lawsuits Target Health Insurers Over Deceptive Practices

Anthem’s case joins a growing list of legal actions targeting health insurers and providers over deceptive practices and network issues. Earlier this year, Anthem settled a massive antitrust case for $2.8 billion, resolving allegations that it underpaid hospitals and physicians. The settlement, the largest of its kind, required Blue Cross Blue Shield to address its payment structures and improve transparency.

BetterHelp, a popular online therapy service, also faces a class action lawsuit alleging that the company misled users about therapist qualifications and data privacy. In a separate case, patients are suing the Aspire Houston Fertility Institute, claiming that the clinic knowingly implanted nonviable embryos in IVF procedures, while Idaho patients have accused Praxis and Interpath of deceptive billing practices.

In their lawsuit, Doe and Cavallaro-Kearins want to represent anyone enrolled in Anthem’s FEHP plans from 2018 who attempted to use Anthem’s directory of mental health providers. They are suing for breach of contract, fraudulent misrepresentation, unjust enrichment, and violations of New York business and insurance laws. They are seeking damages, injunctive relief, interest, costs, and fees.

Case Details

• Lawsuit: Doe, et al. v. Anthem Healthchoice Assurance, Inc., D/B/A Anthem Blue Cross and Blue Shield, et al.
• Case Number: 1:24-cv-08012    
• Court: U.S. District Court for the Southern District of New York  

Plaintiffs' Attorneys

• Steve Cohen (Pollock Cohen LLP)
• Jacob Gardener (Walden Macht Haran & Williams LLP)

Have you experienced difficulties finding mental health providers through Anthem's network? Share your story in the comments below.