Ghost Networks Class Actions

Pollock Cohen LLP and Walden Macht Haran & Williams LLP have filed a fourth class action lawsuit against health insurance companies that are perpetrating fraud by publishing inaccurate directories of doctors - known as "ghost networks" - who supposedly accept the companies’ insurance but, in fact, do not.

The most recent class action complaint was filed in the United States District Court for the Southern District of New York against Healthfirst PHSP, Inc. (“Healthfirst”), a not-for-profit corporation registered to do business in New York, that administers the Healthfirst Essential 200-250 Plan and the Healthfirst Gold Leaf Premier Plan. The complaint alleges that Healthfirst engages in deceptive business practices by knowingly publishing an inaccurate and misleading provider directory. These inaccurate directories are known as “ghost networks.” The Class includes all individuals who have purchased or enrolled in any of Healthfirst’s Qualified Health Plans or Essential Plans—including the Gold Leaf Premier, Essential 200-250, and Essential 1 Plans—in New York at any point from 2019 through the date of class certification.

In July 2025, a class action lawsuit was filed in Connecticut state court against Anthem Blue Cross Blue Shield, Carelon, and their parent company, Elevance, for deceptive business practices and defrauding their customers by denying mandated medical services and intentionally publishing inaccurate directories of doctors. It is a class action lawsuit covering hundreds of thousands of Connecticut residents.

The prior class action lawsuits are against Carelon Behavioral Health (formerly known as Beacon Health Options) and Anthem Blue Cross and Blue Shield of New York. Both companies are owned by the same parent company: Elevance Health. The Carelon lawsuit is on behalf of more than 1.2 million New Yorkers who participate in the NYSHIP/Empire Plan. The case against Anthem is on behalf of almost 150,000 federal employees in New York.

All three lawsuits focus on access to mental health care for adults and children. The complaints detail the stories of plaintiffs who sought out mental health providers for treatment – and relied on the directories published by the health insurance companies – and could not find doctors. Either the doctors listed didn’t exists, didn’t accept the insurance, weren’t specialists in the areas the insurers claimed, or weren’t accepting new patients.

These misleading directories – known as “ghost networks” – not only waste people’s time but can result in people having to spend thousands of dollars on out-of-network doctors. And they can be dangerous, causing people to delay or abandon care.

The Healthfirst complaint is here. 

The Anthem/Carelon/Elevance CT complaint is here. View the News Release here.

The Carelon complaint is here. View the News Release here.

The Anthem complaint is here. View the News Release here.

The grossly inaccurate directories delay many patients’ ability to find in-network care. Thousands of others simply cannot afford to pay for an out-of-network provider, and abandon their search for care – complicating their mental health condition significantly.

The lawsuits focus on access to mental health care for both adults and children. In the Healthfirst complaint, the plaintiff notes how they relied on the Defendant's provider directory and representations regarding its provider network when choosing their health plan, only to be subject to deceptive and misleading representations and omissions. In the Carelon complaint, three plaintiffs share their anguish and frustration dealing with Carelon’s ghost network and detail their stories about calling countless doctors listed in Carelon’s directory – thinking that did not actually accept the Empire Plan. In the Anthem complaint, two plaintiffs share their struggles as well. 

After hearing these stories, attorneys for the plaintiffs conducted extensive “secret shopper” studies to replicate each of the plaintiff’s experiences and called 300 doctors listed in the Carelon directory and 100 doctors listed in the Anthem directory. Only 17% of doctors (51 out of the 300 called) in Carelon and 7% of doctors (7 our of 100) actually accepted the insurance and would see new patients. The remaining doctors either did not accept the insurance, were unreachable, did not accept new patients, or did not provide the type of service listed in the directory.