March 19, 2019

United Behavioral Health Wrongfully Denied Mental Health and Substance Use Coverage

In a class action suit, the United States District Court for the Northern District of California found that United Behavioral Health, the largest managed behavioral health care company in the country, developed review criteria for evaluating the medical necessity of claims for outpatient, intensive outpatient, and residential treatment of mental health and substance use disorders that was inconsistent with generally accepted standards of behavioral health care, and wrongly influenced by a financial incentive to suppress costs. According to the New York Times, “The case represents the latest development in the contentious debate over how health insurance companies cover mental health and substance abuse disorders, as compared to medical conditions like diabetes, multiple sclerosis and asthma.”