Mazzola et al. v. Anthem Health Plans, Inc. et al.

Why This Matters:

Plaintiffs allege that a private health insurer and its subsidiaries maintain a “ghost network” of behavioral health care providers in violation of the Employee Retirement Income Security Act, the No Surprises Act, the Mental Health Parity and Addiction Equity Act, contract law, and state unfair business practice laws. Insurers have been accused of maintaining “ghost networks,” which are provider directories that overstate a plan’s in-network providers through significant errors, duplications, and other inaccuracies. Plaintiffs allege that the insurer does so to artificially inflate its provider network, making the plan appear to have more robust in-network coverage than is actually available.

Potential Impact:

“Ghost networks” can mislead patients, prevent patients from evaluating their coverage options, and force patients to obtain behavioral health care from out-of-network providers or forego treatment altogether.