One of New York\u2019s largest health insurers is set to pay a multimillion-dollar fine for failing to fix a series of errors that made it harder for its customers to get mental health care.<\/p>\n
EmblemHealth this week agreed to a $2.5 million settlement<\/a> with the New York attorney general\u2019s office because of the large number of inaccuracies in its listings of in-network mental health providers, a problem that has persisted for years.<\/p>\n The fine is the biggest secured by the state attorney general\u2019s office in its yearslong quest to clamp down on the chronic problem of provider directory errors, also known as ghost networks. It\u2019s an issue that has led customers to postpone treatment, forgo care and pay for more expensive out-of-network providers.\u00a0<\/p>\n The office found that EmblemHealth overstated the availability of in-network mental health providers and failed to comply with state and federal laws requiring that insurers make mental health care as available as other kinds of medical care.<\/p>\n \u201cHealth insurers cannot mislead consumers with inaccurate provider directories while families are left without care,\u201d Letitia James, the state\u2019s attorney general, said in a statement.<\/p>\n EmblemHealth did not answer ProPublica\u2019s questions. In a statement, a spokesperson said the insurer does \u201cnot admit\u201d to the state attorney general\u2019s findings but agreed to the settlement \u201cto avoid time-consuming litigation.\u201d The spokesperson added that the insurer has \u201cfocused on taking immediate steps to further support our members\u2019 access to care.\u201d<\/p>\n ProPublica\u2019s 2024 series \u201cAmerica\u2019s Mental Barrier<\/a>\u201d examined the ways that ghost networks can limit patients\u2019 access to mental health care. Our reporting showed that the investigation by the state attorney general\u2019s office into the ghost networks was one of the rare instances nationwide where health insurers faced consequences from elected officials<\/a>.\u00a0<\/p>\n Between 2018 and 2024, more than 360 EmblemHealth customers complained to either the insurer, a subcontractor that administered mental health benefits for the insurer or the attorney general\u2019s office about such errors, the settlement said. But EmblemHealth failed to address the issue, the settlement said, even though the insurer had promised to do so as part of a settlement agreement reached in 2011.<\/p>\n