New York Attorney General Letitia James has reached a settlement with MVP Health Plan, requiring the company to reform its mental health provider directory and compensate plan members affected by inaccurate listings. The agreement follows an investigation by the Office of the Attorney General (OAG) into systemic issues within MVP’s network, such as incorrect information in its provider directory that may have prevented some members from accessing care or led them to pay out-of-pocket for treatment outside their network.
The OAG began its investigation in 2023 and used secret shopper calls to contact mental health providers listed in MVP’s online directory. Investigators found that none of the providers listed as accepting new patients were reachable or actually taking new patients, and that MVP lacked a process for regularly verifying providers’ availability.
“New Yorkers seeking mental health care deserve timely, accurate information,” said Attorney General James. “When families turn to their health plans for help, they should be able to trust that the information they are given is reliable, and that they can access care without unnecessary obstacles. Today’s agreement holds MVP accountable for its past failures and ensures that plan members can find and access the help they need.”
Under the settlement terms, MVP must provide financial restitution to eligible members who paid more than necessary for mental health care due to inaccurate provider listings or lack of available in-network options since January 1, 2020. An OAG-approved compliance administrator will oversee this process. Additionally, MVP will pay $250,000 in penalties and costs to New York State.
To prevent similar problems in the future, MVP is required to ensure all listed mental health providers are actively participating in-network, accepting new patients, and reachable. The company must update listings within 15 days when receiving new information and remove providers who do not respond to verification requests or are not accepting new patients.
MVP will also implement a verification process every 90 days by contacting each provider to confirm participation and availability. Protocols must be established for timely responses to member inquiries and a complaint monitoring system created for tracking network access issues.
For at least two years, an OAG-approved compliance administrator will monitor MVP’s adherence to these reforms through periodic audits of directory accuracy and reviews of member access to care. The administrator will also evaluate whether MVP meets network adequacy standards as well as assess reimbursement rates with attention on disparities between mental health services compared with medical or surgical benefits.
As part of the agreement, MVP committed to investing further in improving its mental health provider network by potentially recruiting more psychiatrists—including those treating children—helping providers navigate company systems, or reaching out directly to members about available services.
“NAMI New York State wholeheartedly supports the Attorney General’s action to reform insurer provider networks, because there is no Health Care without Mental Health Care,” said Nathan McLaughlin, Executive Director of the National Alliance on Mental Illness, New York State. “NAMI New York State has consistently called for all health plans to maintain accurate, up-to-date directories and expand access to mental health care in parity with physical health. These directory reforms are critical to preventing ghost networks and ensuring that all New Yorkers—particularly those most vulnerable—can securely and efficiently find in-network care when they need it most. We are grateful that both parties have come to an agreement that ensures access to mental health services. With one in five adults having a diagnosed mental health condition, and one in every ten in recovery from a process or substance use disorder, mental health services are needed now more than ever. The National Alliance on Mental Illness of New York State thanks Attorney General James and her staff for their diligent work ensuring equitable access to mental health services.”
“This year is the 20th anniversary of New York’s passage of mental health insurance parity — Timothy’s Law — yet there are still insurers and plans that have not been compliant with the law,” said Glenn Liebman, CEO of Mental Health Association in New York State. “As a result, individuals and their loved ones have not received needed services. Tough enforcement actions are needed, and we thank Attorney General James and her team for their leadership.”
The matter was managed by Assistant Attorneys General Michael Reisman and Carol Hunt under Health Care Bureau Chief Sudarsana Srinivasan; Assistant Attorney General Gina Bull provided additional support from the Executive Division.
