Ghost Networks Exposed: 82% of Providers Unreachable (Image Credits: Flickr)
New York – EmblemHealth, a leading insurer serving over 3 million people, reached a $2.5 million settlement with the state attorney general’s office for longstanding inaccuracies in its mental health provider directories that impeded customer access to care.[1]
Ghost Networks Exposed: 82% of Providers Unreachable
A state report from 2023 revealed stark problems in EmblemHealth’s directories. Investigators found that 82 percent of listed mental health providers could not be reached, were out of network, or declined new patients.[1]
Customers often discovered these issues only after seeking appointments. Many paid out of pocket or skipped treatment altogether. The inaccuracies violated laws mandating parity between mental health and physical health coverage. ProPublica’s reporting in 2024 spotlighted how such “ghost networks” created nationwide barriers to care.[1]
Complaints Piled Up Over Six Years
Between 2018 and 2024, more than 360 complaints reached EmblemHealth, its subcontractor, or the attorney general about directory flaws. The insurer’s internal probes confirmed similar shortcomings.
EmblemHealth had pledged fixes in a 2011 settlement but fell short. A broader 2023 attorney general probe examined 13 insurers, including nearly 400 providers, and uncovered widespread unavailability. New York City employees even filed a lawsuit in December, claiming the lists deceived them about network size.[1]
Settlement Mandates Compensation and Overhauls
The February 2026 agreement marked the largest of its kind from the New York attorney general for directory errors. EmblemHealth committed to reimbursing customers who incurred extra costs for mental health services due to the issues.
Key reforms include correcting errors within two business days of notification and verifying listings every 90 days. An independent monitor will ensure compliance. The insurer avoided admitting fault to sidestep litigation. Here are the main terms:
- $2.5 million payment to the state.
- Customer reimbursements for out-of-pocket expenses.
- Rapid error corrections and quarterly verifications.
- Oversight by an external auditor.
Officials Demand Change Amid Broader Crisis
Attorney General Letitia James declared, “Health insurers cannot mislead consumers with inaccurate provider directories while families are left without care.”[1]
An EmblemHealth spokesperson noted the company does not admit the findings but agreed to resolve the matter quickly. The insurer emphasized recent efforts to bolster member access. This case stands out as rare accountability in the fight against ghost networks.
- Ghost networks affect mental health parity nationwide.
- EmblemHealth’s settlement sets a precedent for enforcement.
- Patients may now claim reimbursements for past hardships.
This resolution pushes insurers toward reliable directories and easier care access. It signals growing scrutiny on practices that delay mental health treatment. What experiences have you had with provider directories? Tell us in the comments.