Harvard Pilgrim class action lawsuit alleges ‘ghost network’ fraud

Harvard Pilgrim class action overview:

• Who: Plaintiffs Jessica Bousquet and Brian Green filed a class action lawsuit against Harvard Pilgrim Health Care Inc. and Point32Health Inc.
• Why: Bousquet and Green allege Harvard Pilgrim maintains a “ghost network” of mental health providers that is largely illusory.
• Where: The Harvard Pilgrim class action lawsuit was filed in Massachusetts state court.

A new class action lawsuit alleges that health insurer Harvard Pilgrim Health Care has been deceiving members by publishing a grossly inaccurate directory of mental health providers.

Plaintiffs Jessica Bousquet and Brian Green filed the class action complaint against Harvard Pilgrim Health Care and its parent company Point32Health, alleging the defendants maintain what is known as a “ghost network” of behavioral health providers.

The class action lawsuit defines a ghost network as “a directory of supposedly available, in-network providers that contain so many incorrect or duplicative entries that the network is largely illusory.”

The plaintiffs allege that despite Harvard Pilgrim’s representations of a broad mental health provider network, most listed providers are unavailable — they are no longer practicing, not actually in-network, not accepting new patients or simply unreachable.

Secret shopper studies conducted by plaintiffs’ counsel in April 2026 found ghost rates of up to 81.6%, meaning the vast majority of providers listed in the directory could not be used to schedule an in-network appointment.

Bousquet, who pays approximately $510 per month for her plan, claims she called approximately 60 providers and spent 10-20 hours searching before going without in-network mental health care for 16 months.

Green and his family, the complaint alleges, pay approximately $580 per month for their plan and were similarly unable to locate an in-network therapist for himself or his minor son, ultimately resorting to out-of-network care at approximately $120 per visit.

Harvard Pilgrim allegedly benefited financially from ‘ghost network’ fraud

Bousquet and Green claim Harvard Pilgrim knowingly maintained the inaccurate directory to attract enrollees, collect premiums and reduce insurance payouts, financially benefiting from members’ inability to access promised care.

The Harvard Pilgrim class action lawsuit alleges violations of Massachusetts General Laws Chapter 93A for deceptive acts and practices, along with claims for breach of contract, fraudulent misrepresentation and unjust enrichment.

The plaintiffs seek to represent all individuals who have purchased or enrolled in any of Harvard Pilgrim’s plans in Massachusetts on or after May 6, 2020, and request a jury trial and certification of the class action lawsuit.

They are demanding compensatory damages, treble damages, punitive damages and injunctive relief requiring Harvard Pilgrim to maintain an accurate provider directory.

Currently, Blue Shield of California and Magellan Health are facing similar accusations that they maintained a “ghost network” of mental health providers in California.

What do you think of these “ghost network” allegations made in this Harvard Pilgrim class action lawsuit? Let us know in the comments.

The plaintiffs are represented by Ana Isabel Muñoz of Zalkind Duncan & Bernstein LLP, Steve Cohen of Pollock Cohen LLP and Jacob Gardener of Walden Macht Haran & Williams LLP.

The Harvard Pilgrim class action lawsuit is Bousquet, et al. and Green v. Harvard Pilgrim Health Care Inc., et al., in the Suffolk County Superior Court of Massachusetts.

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