EmblemHealth Hit with $2.5M Fine for Mental Health 'Ghost Networks'

One of New York's largest health insurers agrees to settlement over inaccurate provider listings.

Published on Feb. 26, 2026

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EmblemHealth, one of New York's largest health insurers, has agreed to a $2.5 million settlement with the New York Attorney General's office over persistent inaccuracies in its listings of in-network mental health providers. The settlement addresses the problem of 'ghost networks' - provider directories that list clinicians who are unreachable, no longer accepting patients, or not actually part of the insurer's network.

Why it matters

The $2.5 million fine represents the largest secured by the state attorney general's office in its efforts to combat inaccurate provider directories, an issue that has led patients to postpone treatment, forgo care altogether, or pay higher costs for out-of-network services. The settlement comes as EmblemHealth also faces a lawsuit filed by employees of the city of New York alleging that the inaccuracies in the insurer's directory created a 'deceptive' and 'misleading' impression about the size of the company's provider network.

The details

According to the Attorney General's office, EmblemHealth overstated the availability of in-network mental health providers and failed to comply with state and federal laws requiring equitable access to mental health care. The investigation revealed that between 2018 and 2024, more than 360 EmblemHealth customers filed complaints regarding access issues. A 2023 report from the Attorney General's office examined 13 insurers, including EmblemHealth, and found that 82% of the providers listed in EmblemHealth's directory who were contacted were unavailable for appointments.

  • The $2.5 million settlement was announced this week.
  • The investigation covered the period from 2018 to 2024.
  • A previous settlement agreement with EmblemHealth was reached in 2011.

The players

EmblemHealth

One of New York's largest health insurers, covering more than 3 million people in New York and surrounding states.

Letitia James

New York Attorney General, who stated that "Health insurers cannot mislead consumers with inaccurate provider directories while families are left without care."

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What they’re saying

“Health insurers cannot mislead consumers with inaccurate provider directories while families are left without care.”

— Letitia James, New York Attorney General

What’s next

Under the terms of the settlement, EmblemHealth will compensate customers who incurred out-of-pocket expenses for mental health care due to the inaccurate directory information. The insurer has also pledged to take corrective action to improve the accuracy of its listings, promising to correct errors within two business days of notification and to verify the accuracy of each listing every 90 days. An independent monitor will be appointed to oversee EmblemHealth's progress and ensure compliance with the settlement's terms.

The takeaway

The EmblemHealth settlement highlights the ongoing issue of 'ghost networks' in the health insurance industry, where provider directories list clinicians who are unavailable or not actually part of the insurer's network. This practice has led to patients postponing or forgoing mental health care, underscoring the need for greater transparency and accountability from insurers to ensure equitable access to care.