March 14, 2023
Payers | Tea Leaves
  • Thousands of patients have called on a federal court to reverse a landmark ruling allowing a UnitedHealth Group subsidiary to develop mental and substance abuse coverage guidelines they allege deviate from clinical standards. The American Medical Association, the American Psychiatric Association, multiple states, and others have submitted amicus curiae briefs in support of the appeal. The case stems from two consolidated class-action lawsuits filed against United Behavioral Health in 2014, in which plaintiffs alleged the insurer breached its fiduciary duty under the Employee Retirement Income Security Act of 1974 by developing unreasonable criteria to deny mental health and substance abuse treatment. (Articles here and here)