The American Psychiatric Association and the New York State Psychiatric Association filed a lawsuit in federal court Dec. 30, 2025, against New York City-based EmblemHealth, alleging the insurer operates a deceptive “ghost network” of mental health providers.
The complaint accuses EmblemHealth of falsely inflating the size of its mental health provider network by listing clinicians who are not available to see patients. According to the filing, the insurer allegedly misrepresented in-network offerings “to attract more members, and therefore more premiums and/or administrative fees.”
The associations further allege that a majority of EmblemHealth’s directories include duplicate entries for the same mental health provider — in one case, a single psychiatrist appeared 29 times. The directories also list nonphysician providers, such as nurse practitioners and social workers, and include providers affiliated with private entities.
The lawsuit describes this as a systemic issue that obstructs members’ ability to obtain timely and effective mental health treatment, often forcing patients to pay out-of-network rates or forgo care altogether. The filing states that approximately half of the listed psychiatrists are either telehealth-only or serve only hospital inpatients.
The plaintiffs are pursuing injunctive relief and unspecified monetary damages.
When reached by Becker’s, a spokesperson for EmblemHealth declined to comment, citing the pending litigation.
