The mother of an Arizona man who died after being unable to find mental health treatment is suing his health insurer, saying it broke the law by publishing false information that misled its customers.

Ravi Coutinho, a 36-year-old entrepreneur, bought insurance from Ambetter, the most popular plan on HealthCare.gov, because it seemed to offer plenty of mental health and addiction treatment options near his home in Phoenix. But after struggling for months in early 2023 to find in-network care covered by his plan, he wasn’t able to find a therapist. In May 2023, after 21 calls with the insurer without getting the treatment he sought, he was found dead in his apartment. His death was ruled an accident, likely due to complications from excessive drinking.

Coutinho was the subject of a September 2024 investigation by ProPublica that showed how he was trapped in what’s commonly known as a “ghost network.” Many of the mental health providers that Ambetter listed as accepting its insurance were not actually able to see him. ProPublica’s investigation also revealed how customer service representatives and care managers repeatedly failed to connect Coutinho to the care he needed after he and his mother asked for help. The story was part of a yearlong series, “America’s Mental Barrier,” that investigated the ways insurers employed practices that interfered with their customers’ ability to access mental health care.

  • flandish@lemmy.world
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    2 days ago

    shareholders and board members in corporations that do this nonsense need to be criminally charged and given appropriate sentences. corps want “rights” like humans and shareholders want corps to put profit first? then they can all be treated like the motherfucking criminals they are.

    • flandish@lemmy.world
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      2 days ago

      yes. i mean ALL shareholders. all it’ll take is once and the whole system will change when grandma goes to jail because her 401k has stock in this criminal entity.

      • shaiatan@midwest.social
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        2 days ago

        Don’t get me wrong - this is absolute bullshit, but no, that’s a bad take.

        The people that regulate this don’t give a shit if the average person is prosecuted because it doesn’t affect them. The only actual way the system gets changed is if the obscenely wealthy/regulators/lawmakers who profit over this go to jail. Not some schmuck with a 401(k).

        You penalize folks that happen to have a single share of this in their retirement portfolio, all you’re doing is screwing over the chunk of the populace that is already overworked and just trying to survive by shoving what they can into recommended retirement funds.

        • ImADifferentBird@lemmy.blahaj.zone
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          2 days ago

          Not to mention that most people have no idea what’s in their 401k. They just stick it into a mutual fund or agree to the company advisor or something and let it go.

          If you really want to do something that will encourage change, stop thinking about jailing the worker with the 401k and start thinking about jailing the board and the C-suite.

          • flandish@lemmy.world
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            2 days ago

            jail them according to proportions owned. this will get the C suite life and grandma a fine and will get the ones who see this happen actually making change, in the manners necessary.

            • Maeve@kbin.earth
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              2 days ago

              No, I see value in Grand doing 24 hours of community service in some sort of mental/physical health settings for poor people. That way she sees what she and her friends and family are facing, one major medical event away. Let her tell everyone about those turned away.

              • flandish@lemmy.world
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                2 days ago

                ok. works for me. i just think that if soup-to-nuts people “felt” the choices the corporations made in ways they actually felt - wallet or free time - things will change. corps will be dissolved. c suites jailed. yadda yadda.

                “what are you in for?”

                “i was majority shareholder in a corp that chose profit over people.”

          • shaiatan@midwest.social
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            2 days ago

            You’re actively advocating for citizens to be punished for decisions made by people in the ruling/investment class, while also advocating they commit violence that they will be jailed for. That’s honestly kind of impressive.

            Maybe try fining the people that pick the investments instead?

            • flandish@lemmy.world
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              2 days ago

              fining? fining does not work on the owning classes. that’s “just business.”

              they. need. prison.

              • shaiatan@midwest.social
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                2 days ago

                You 100% ignored my response.

                I said initially said to jail the fucks fueling this. You then said we should penalize the people with 401(k)s. I tried to shift the blame back to the people actually picking the damn stocks.

                • flandish@lemmy.world
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                  2 days ago

                  i’m saying proportional response is the key - the ppl picking the stocks and the people owning them. i 100% included your cohort in my response. they ALL need to be given credit for these corporate crimes.

      • JcbAzPx@lemmy.world
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        2 days ago

        I’d be fine with the compromise that your sentence should be proportional to your level of stake in the company. So, grandma’s .00001 shares would get her community service, while the 51% holder gets life.

        • shaiatan@midwest.social
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          2 days ago

          Yep, grandma, who had maybe a base level of knowledge of where her retirement was invested, should serve time for the fact that the funds her advisor picked happened to contain a share of this company.

          Not, you know, the fund advisor that actually understands what she’s investing in.

          • JcbAzPx@lemmy.world
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            2 days ago

            Who said serve time? I’d say five minutes of community service or a ten cent fine would be enough. Plus it could serve as incentive to take control of their own money and be sure it’s not invested in criminal enterprises.

            • shaiatan@midwest.social
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              2 days ago

              Not, you know, the fund advisor that actually understands what she’s investing in.

              No. You want to punish someone? Punish the people choosing the investments.

              • JcbAzPx@lemmy.world
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                1 day ago

                You can punish them too, but if you absolve anyone behind a third party, all the billionaires in control would only own stocks through “blind” trusts and defeat the purpose of punishing the owners of criminal corporations.

      • thefartographer@lemm.ee
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        2 days ago

        Look, either Grandma is contributing waaaaayyyyyyy too much to her 401k, or Grandma’s portfolio is tied up in a bunch of small shitty companies or it’s all in one slightly less small shitty company. Whatever it is, if Grandma’s monthly contributions are enough to have a controlling vote in a company, she needs a new financial advisor.

        • flandish@lemmy.world
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          2 days ago

          haha true. but when I send money to hamas, I’m “supporting terrorists.”

          but grandma allows her money to be sent to a corp that chooses to kill people and … she’s just little ole grandma?

          pfft. :p

          • thefartographer@lemm.ee
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            2 days ago

            Why are you sending your money to Hamas? That’s a bad retirement plan, too. You’re supposed to stuff all your money into your mattress.

            That’s why you spend the first 20 years of your career buying various mattresses, so that you’ll have enough storage for when you retire as a billionaire. And when the government wants you to pay for taxes, you just send them a mattress.

            • flandish@lemmy.world
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              2 days ago

              haha i am of course not sending money to hamas lol. it’s just to prove a point in the thread.

          • shaiatan@midwest.social
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            2 days ago

            At this point, I’m being redundant, but:

            To “send money to hamas” you need to actively do so. To “alllow her money to be sent to a corp that chooses to kill people” - that’s literally retirement in the US?

            I’m literally not saying it’s a good thing but - not understanding the difference between these two is an impressive level of cognitive dissonance.

            • flandish@lemmy.world
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              2 days ago

              of course I understand the difference - you don’t seem to understand how proportional response would work when grandma is told her 401k is fined because she funded a murderous corporation. her fund manager gets a few days time. the corporation c suite gets months and the board gets decades.

  • Jessica@lemmy.blahaj.zone
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    1 day ago

    I owe my psychiatrists office thousands, because none of my employer provided insurance options has ever covered it. The best “coverage” I had was up to 10 therapist visits per year. No coverage of the medical visits, and when I needed therapy every other week, they did not cover any of it. I’m lucky that they have not cut me off. And if they do cut me off, I’m properly fucked. I can’t go off of my meds, I just can’t function properly without them. I’d quickly end up in a very serious situation.

    • AnarchistArtificer@slrpnk.net
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      23 hours ago

      That’s a really sucky situation to be in. I’m glad that they haven’t cut you off, but I can imagine that the stress of the possibility makes engaging with therapy harder than it should be.

      • Jessica@lemmy.blahaj.zone
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        23 hours ago

        It really highlights for me, the lack of empathy of the insurance companies, and the general public at large. They want people like me to be functioning members of society, but don’t care enough to offer proper resources for us. My mania results in destructive impulsivity, in combination with extreme emotional/mood swings that make maintaining relationships exhausting for those around me. The meds help keep me evened out enough to function. People don’t understand the plight of those with mental disorders (and mine is nothing compared to those who have it much worse), so they respond with apathy most of the time.

  • Feelfold@lemm.ee
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    2 days ago

    Most insurance plans don’t cover mental health beyond trivial interactions for a trivial period of time. Most metal healh professionals don’t accept insurance because they can’t afford to. After a decade between school and “volunteering”, insurance companies offer a wage that could easily be made with far less stress, responsibility, and accountability. Earnings can be “clawed back” by an insurane company at any time.

    Most insurance companies don’t provide out of network benefits, because they can make more profit by exploiting customers and labor. Often pitting them against each other to avoid any responsibility.

    MHPAEA is a fucking joke. For profit healthcare should be illegal.

  • dinren@discuss.online
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    2 days ago

    Mine isn’t as bad as that, but I went through a dozen listings before I found an up to date one. The information is so old sometimes. One place I called said that doctor had not even been there for two years. Just lazy people

    • liverbe@lemmy.world
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      2 days ago

      It’s not a bug. it’s a feature. Because if you don’t get the care you need, they don’t have to pay! 😡

      “Navigating the Healthcare system” is code for: Good luck suckers!!!

  • andros_rex@lemmy.world
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    2 days ago

    Don’t forget, there is basically no oversight on therapists, so if your therapist tells you you should quit your job to “submit” to your husband, then disappears after a week or so of torture, meaning that you navigate a divorce with zero access to domestic violence supports, your life is over and there is no consequences!

    • ickplant@lemmy.world
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      2 days ago

      There is a lot of oversight on therapists, every state has a regulatory board. We have to go through thousands of client hours before getting our license, which can get revoked if we do anything illegal or unethical. Maybe you’re thinking of life coaches?

          • andros_rex@lemmy.world
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            2 days ago

            Regulatory boards can exist but only choose to meet a few times a year, refuse to investigate anything that happens to a certain class of people, and also just not want to do their jobs because social services and regulatory agencies are like weekend clubs here.

            Things are not working to the point I am trying to whistleblow a decades long “industrially scamming the free school lunch funds” and no one gives a shit. No one gives a shit about anything, Jesus Christ it’s Oklahoma. There are no consequences for anything here.

  • aceshigh@lemmy.world
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    2 days ago

    Seems like this is a state by state issue. I didn’t have this issue on Medicaid or paid for insurance (not marketplace).