Doe et al. v. Carelon Behavioral Health, Inc.

Why This Matters:

Plaintiffs allege that a behavioral health services vendor that administers mental health services for many private health plans maintains a “ghost network” of mental health care providers in violation of deceptive advertising and 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 health care from out-of-network providers or forego treatment altogether.