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March 12, 2021

UnitedHealthcare Faces Class Action Over Refusal to Cover Proton Beam Therapy

Several plaintiffs have sued UnitedHealthcare Insurance (United) over allegations that the insurer systematically has denied coverage for proton beam therapy. Participants allege that the therapy, while more expensive, is also more effective in cancer treatment. Plaintiffs argued that the treatment has been approved by FDA since 1988, shown safe and effective by medical organizations and regularly recommended and used by medical facilities and providers. The United States District Court for the District of Massachusetts agreed with plaintiffs and denied United’s 12(b)6 motion.

United considers proton beam therapy experimental unless it is used to treat prostate cancer. Several other insurers have also been hit with class suits in recent years for their failure to cover proton beam therapy, including Humana Insurance, Blue Shield of California and Blue Cross Blue Shield of North Carolina.