A group of New York state employees is suing Carelon Behavioral Health, alleging the health benefits provider knowingly maintained inaccurate directories of mental health providers, referred to in the lawsuit as “ghost networks.”
In a proposed class-action lawsuit filed in U.S. District Court for the Southern District of New York on April 28, three New York State Health Insurance Program members alleged Carelon maintained a “grossly inaccurate” directory of physicians and therapists.
Carelon is the health services arm of Elevance Health. It contracts with New York to administer mental health benefits for state employees, according to the lawsuit.
The lawsuit is the second in less than a year alleging Elevance’s subsidiaries have inaccurate directories for mental health providers. In October, two members of Anthem Blue Cross Blue Shield, a health plan owned by Elevance, sued, alleging the health plan maintained ghost networks. In the October case, the plaintiffs alleged there are “almost no” mental health providers in New York that accept Anthem BCBS.
The plaintiffs alleged Carelon “knowingly publishes an inaccurate and misleading provider directory” to attract potential customers, and to appear to comply with state and federal network requirements.
The proposed class in the lawsuit consists of “many thousands” of state and municipal employees in New York, attorneys for the plaintiffs wrote.
In April, Anthem reached a settlement in a case alleging its standards for residential mental health coverage were unnecessarily strict.
Becker’s has reached out to Elevance Health for comment and will update this article if more information becomes available.
