News Summary
MVP Health Care has agreed to a $250,000 settlement in New York due to a significant inaccuracy in its mental health provider directory. An investigation by Attorney General Letitia James revealed that 86% of listed providers were unreachable or incorrect, complicating access for patients needing mental health services. The settlement mandates improvements to the provider directory, including regular updates and reimbursements for out-of-network services, emphasizing the need for transparency in mental health care access.
Albany, New York – MVP Health Care has agreed to pay $250,000 to the state of New York as part of a settlement addressing serious inaccuracies in its mental health provider directory. This resolution comes after a thorough investigation led by New York Attorney General Letitia James, which unveiled the prevalence of “ghost” provider networks that mislead consumers seeking mental health care.
The investigation revealed that an alarming 86% of the mental health providers listed in MVP’s directory were either unreachable, not accepting new patients, or out of network. To substantiate these findings, the Attorney General’s office conducted a study employing “secret shoppers,” who reported being unable to successfully book appointments with any of the listed providers. This situation exemplifies a larger systemic issue in New York, where a 2023 report indicated that 3 million residents are grappling with mental health issues, with one-third unable to access necessary treatment.
Several factors contribute to this lack of access, notably that many providers do not accept the patients’ insurance. As part of the settlement, MVP has committed to overhauling its mental health provider directory to ensure its accuracy, which includes contacting each listed provider every 90 days to confirm their participation. Furthermore, MVP is mandated to reimburse members who sought care from out-of-network providers based on inaccuracies in the directory, with restitution applicable for services dating back to January 1, 2020.
The issues uncovered in MVP’s directory are not isolated. During the same investigation, another New York insurer, CDPHP, was identified as having a staggering 92% ghost rate, indicating a significant number of listed providers were not available to patients. However, CDPHP has yet to settle with the Attorney General’s office. In contrast, Cigna emerged as the best performing insurer during the review, yet still had a ghost rate of 65%, highlighting a widespread problem within the state’s health insurance landscape.
Attorney General Letitia James underscored the necessity for reliable information from health plans to help families access the care they need without unnecessary barriers. To enhance compliance and monitoring, MVP is also required to hire a representative approved by the Attorney General’s office to oversee the company’s adherence to the new guidelines for a period of two years following the settlement.
The investigation’s findings have shed light on the confusion and frustration faced by patients trying to locate in-network providers within directories that are fraught with inaccuracies. In response, MVP has stated its intention to implement measures aimed at improving transparency and access to behavioral health care. This includes investments in telehealth services and efforts to recruit more mental health providers in response to the growing demand for care.
This settlement represents a significant step toward improving mental health care accessibility in New York and aligns with broader efforts to ensure that individuals can obtain the treatment they require without encountering obstacles created by misleading provider directories.
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Additional Resources
- Daily Gazette: MVP Health Care Fine for Mental Health Directory Inaccuracies
- Wikipedia: Mental Health
- CBS6 Albany: Family Room in Schenectady Provides Haven for Teens
- Google Search: Mental Health Services New York
- News 10: Ellis Hospital Reopens Inpatient Youth Mental Health Unit
- Google Scholar: Mental Health Accessibility New York
- Times Union: Schenectady Police Propose Mental Health Crisis Team
- Encyclopedia Britannica: Mental Health Services
- Times Union: Ellis Medicine’s Family Room Offers Mental Health Support
- Google News: Mental Health Directory Inaccuracies
Author: STAFF HERE NEW YORK WRITER
NEW YORK STAFF WRITER The NEW YORK STAFF WRITER represents the experienced team at HERENewYork.com, your go-to source for actionable local news and information in New York, the five boroughs, and beyond. Specializing in "news you can use," we cover essential topics like product reviews for personal and business needs, local business directories, politics, real estate trends, neighborhood insights, and state news affecting the area—with deep expertise drawn from years of dedicated reporting and strong community input, including local press releases and business updates. We deliver top reporting on high-value events such as New York Fashion Week, Macy's Thanksgiving Day Parade, and Tribeca Film Festival. Our coverage extends to key organizations like the Greater New York Chamber of Commerce and United Way of New York, plus leading businesses in finance and media that power the local economy such as JPMorgan Chase, Goldman Sachs, and Bloomberg. As part of the broader HERE network, including HEREBuffalo.com, we provide comprehensive, credible insights into New York's dynamic landscape.
