A man committed suicide after he was unable to get mental health care, and his mother is suing the insurance company because their directory of providers was completely inaccurate.
She are claiming that the company was falsely claiming that there were in-network mental health professionals when there were none.
This is a very common thing for insurance companies to do:
The mother of an Arizona man who died after being unable to find mental health treatment is suing his health insurer, saying it broke the law by publishing false information that misled its customers.Ravi Coutinho, a 36-year-old entrepreneur, bought insurance from Ambetter, the most popular plan on HealthCare.gov, because it seemed to offer plenty of mental health and addiction treatment options near his home in Phoenix. But after struggling for months in early 2023 to find in-network care covered by his plan, he wasn’t able to find a therapist. In May 2023, after 21 calls with the insurer without getting the treatment he sought, he was found dead in his apartment. His death was ruled an accident, likely due to complications from excessive drinking.
Coutinho was the subject of a September 2024 investigation by ProPublica that showed how he was trapped in what’s commonly known as a “ghost network.” Many of the mental health providers that Ambetter listed as accepting its insurance were not actually able to see him. ProPublica’s investigation also revealed how customer service representatives and care managers repeatedly failed to connect Coutinho to the care he needed after he and his mother asked for help. The story was part of a yearlong series, “America’s Mental Barrier,” that investigated the ways insurers employed practices that interfered with their customers’ ability to access mental health care.
The lawsuit, filed on May 23 in Maricopa County by Coutinho’s mother, Barbara Webber, accused the insurer Centene, along with the subsidiary that oversaw her son’s plan, Health Net of Arizona, of publishing an “inaccurate and misleading” provider directory. The suit also accused the companies of breaking state and federal laws, including ones that require directories to be kept accurate.
In case you are unaware, it works like this: The insurance company lists hundreds of mental health professionals in their directory, but most (all?) of them are either not taking new patients, or they have left the network.
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The lawsuit also describes how Arizona insurance regulators had previously informed Health Net of Arizona that it had failed to maintain accurate provider directories. Health Net of Arizona promised to correct the errors. Regulators did not fine the insurer and declined to answer ProPublica’s questions about whether the Centene subsidiary addressed their concerns.
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One of the 25 largest companies in America, Centene and its subsidiaries have been accused in past lawsuits of purposefully misrepresenting the number of in-network providers by publishing inaccurate directories. Centene lawyers have previously denied such claims in two of the bigger cases, in Illinois and California. Both cases are ongoing.
The top trade group for the industry, AHIP, has told lawmakers that companies contact in-network providers to ensure the listings are accurate. AHIP also stated that the companies could correct inaccuracies faster if providers did a better job updating their listings. Providers have told ProPublica, however, that insurers don’t always remove their names from insurer lists when they officially request to leave their networks.
The insurers have no incentive to keep their directories accurate. If they had to list the practices that had closed to new patients and remove the listings for companies that have told them to pound sand, it would be clear to people shopping for insurance that their coverage sucks, and people would not buy their insurance and pay their premiums.
Their solution, rather unsurprisingly, is to defraud their customers.
We need to start prosecuting this sort of bullsh%$.
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