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The mother of an Arizona man who died after failing to find mental health treatment is suing his health insurance company, saying he broke the law by publishing misinformation that misinterpreted a client.
Ravi Coutinho, a 36-year-old entrepreneur, bought insurance from Ambetter, the most popular plan on Healthcare.gov, as it appears to offer plenty of mental health and addiction treatment options near her home in Phoenix. However, after struggling for months in early 2023 to find in-network care to be covered by his plan, he was unable to find a therapist. In May 2023, he was found dead in his apartment after making 21 calls to the insurance company without the treatment he wanted. His death was determined to be an accident, possibly due to complications from excessive drinking.
Coutinho was the subject of a September 2024 survey by Propobrica, which showed how it was trapped in what is commonly known as the “ghost network.” Many of the mental health providers Ambetter listed as accepting the insurance didn’t actually see him. In a Propublica survey, customer service representatives and care managers revealed that he and his mother were unable to connect Coutinho to the care they needed after he and his mother asked for help. The story was part of the one-year series, “The Psychological Barriers in America,” which examined how insurance companies adopted practices that hinder clients’ ability to access mental health care.
The lawsuit, filed May 23 by Coutinho’s mother, Barbara Weber, in Maricopa County, denounced the insurance company’s sentence and the subsidiary that oversaw the Arizona Health Net, a plan for her son to publish an “inaccurate and misleading” provider directory. The lawsuit also denounced companies breaking state and federal laws, including those that require the need to keep directories accurate.
An error in the Ambetter directory caused Coutinho to give a false impression of the types of mental health care that are actually available, the lawsuit said. The lawsuit stated that the Centene company was providing poor service through its Ambetter plan because it could not fix these errors.
The lawsuit is based on the results of Propopavica’s investigation and summarises Coutinho’s attempt to find a therapist in an ambetter’s network and connect him with a mental health provider who can actually see him with representatives from the Senne.
The lawsuit explains that Arizona insurance regulators had previously informed Arizona’s health net that they were unable to maintain an accurate provider directory. Arizona Health Net has committed to fixing the error. The regulators did not fine the insurance company and declined to answer Propublica’s questions about whether Centene’s subsidiary addressed the concerns.
Arizona’s Centene and Health Net did not respond to multiple requests for comment on the lawsuit. Propublica previously contacted Arizona Senten and Healthnet over two dozen and sent out a detailed list of questions. None of their media representatives responded.
Centene, one of the 25 largest companies in the United States, and its subsidiary, have been charged in previous lawsuits that they intentionally misrepresented the number of providers in their network by publishing inaccurate directories. St. Neane’s lawyers have previously denied such claims in two major cases, Illinois and California. Both cases are underway.
Insurance companies were not compliant with the Mental Health Coverage Act, the Ministry of Labor report found
AHIP, the industry’s leading trading group, told lawmakers that companies will contact in-network providers to ensure the list is accurate. Ahip also said that businesses can fix inaccuracies faster if providers improve list updates. However, the provider told Propublica that when insurers formally request that they leave the network, they don’t always remove their names from their insurance companies’ list.
Mel C. Orchard III, a partner at Spence’s law firm, who represents Weber, told Propobrica that it was intended to hold Senten liable for negligence and consumer fraud with the intention of filing a lawsuit before the ju trial. The lawsuit does not state the specified amount Weber seeks damages.
“Ravi is an example of a rogue failure in the insurance industry that didn’t do what they should have done. It’s ensuring us when we need it most,” Orchard told Propovica. “Instead, they prey on our vulnerability. That’s what happened in this case.”
