The System Is Rigged Against Therapists: Here’s How to Push Back
In 2025 alone, state insurance commissioners have fined some of the largest insurers in the country over $20 million for mental health parity violations, directory inaccuracies, and improper claims handling.
Let that sink in.
UnitedHealthcare, Cigna, Anthem, Premera, and others were penalized- not for one-time mistakes, but for systemic patterns of behavior that violate state and federal laws. These violations directly harm clients, therapists, and the communities we’re trying to serve.
And the fines? They’re a fraction of these companies’ quarterly profits.
This system is not broken; it’s working exactly as it was designed to: to extract as much profit as possible from unpaid or underpaid clinical labor while hiding behind the language of accessibility.
If you're a therapist who's tired, underpaid, overworked, or stuck trying to fix a broken system from within... this is your reminder:
You don't have to participate in the exploitation.
You can push back. And yes, it makes a difference.
What’s Really Going On: The 2025 Highlights
Let’s take a look at some recent headlines:
Georgia fined 22 insurers over $20 million for over 6,000 violations of mental health parity laws, including using prior auth when it wasn't medically necessary and misclassifying benefits.
Premera Blue Cross was fined $550,000 by Washington State for inaccuracies in its provider directories (a key factor in ghost networks). Fun fact- they got a head’s up that there were problems and just… didn’t fix it.
UnitedHealthcare paid over $4.4 million in combined fines across two states for improper claims handling.
Anthem Blue Cross in California was fined $1.8 million for repeated violations, including delays in care and erroneous denial letters.
Cigna was fined for multiple violations totaling $503,000.
Meanwhile, Centene requested a 54% rate increase on ACA plans in Arkansas- at the same time that enhanced premium subsidies are set to expire, which could leave 24.3 million people without affordable coverage.
And therapists are expected to quietly go along with it…?
What You Might Not Realize
Even if you're out-of-network or private pay:
You still need to check if your NPI is being used on ghost networks.
If you struggle to navigate networks to provide referrals that could be a sign that those directories are out of compliance. The laws say this should be clear and easeful.
You can and should submit complaints to your state’s Department of Insurance.
You can educate your clients on their rights and how to file appeals or Independent Medical Reviews.
You don’t have to stay on panels that violate your ethics or your financial wellbeing.
Therapists are often taught to play nice, to stay silent, and to "be grateful" for the privilege of doing this work. But compliance with dysfunction is not ethical care. This is not about entitlement, it’s about integrity.
What You Can Do (Yes, Even Solo)
Here’s a short action list, especially if you're wondering what real advocacy looks like outside of social media debates:
1. Learn who your insurance commissioner is
This is the person approving those rate hikes, overseeing those fines, and determining whether your complaint gets taken seriously. Learn their name. Save their number. Use it. Here is a link to the insurance commissioners by state. In some states they are elected, in others, they are appointed. Learn the process for your state, and let’s make some noise.
2. Check for ghost network abuse
Are you listed on insurance websites even though you’re not on their panel? Are former colleagues still listed even though they’ve moved, retired, or passed away? Document it. Report it. Is it unclear if people are taking new clients, is contact information out of date or nonexistent? Do they include accessibility information? Keep a tally and let’s inform those commissioners.
3. Keep records of your terminations
If you’ve submitted a panel resignation, keep the date-stamped confirmation. Take screenshots 3–6 months later if you're still listed. These are key pieces of evidence in state investigations.
4. Document failed referral attempts
If you’ve tried to use a panel directory and failed to find someone available, document it. File those findings with your insurance commissioner. That is data that matters.
5. Educate your clients on their rights
Help them understand the difference between an internal appeal, an Independent Medical Review (IMR), and when/how to file complaints with the Department of Insurance. You can’t do it for them — but you can point the way.
6. Choose your panels (or no panels) with intention
Every time we say yes to a panel that pays below a living wage, we send a signal that it's okay to continue exploiting clinicians. You can serve your community without being complicit in your own devaluation. And yes, a living wage does include being able to pay down your student loans and take time off for being sick. It does NOT mean living paycheck to paycheck.
This Isn’t Just a Blog. It’s a Call to Action.
Therapists: If you're tired of feeling powerless in the face of systemic dysfunction, you are not alone. This isn’t just about burnout. This is about reclaiming your autonomy, your energy, and your ability to practice ethically.
Let’s stop asking broken systems to fix themselves.
Let’s stop believing we’re the only ones struggling.
Let’s stop tolerating wage theft and pretending it’s “just part of the job.”
Want to See What It Looks Like to Do Things Differently in Private Practice?
Join our next free training, Success Stories: Therapists Thriving Beyond the System:
📅 Date: August 26, 2025
🎙️ Featuring a therapist who went from $10K to $25K/month without selling their soul or abandoning their values.
🧠 They’re using AI to serve their clients, not to exploit themselves.
(yes it will be recorded if you can’t attend live)
We’ll show you what’s possible not with hustle, but with strategy, clarity, and the kind of support this field has always deserved.
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