In Case You Haven't Heard…

In what The New York Times called “a scathing decision,” a federal judge has ruled that UnitedHealth Group illegally discriminated against patients with mental and substance use disorders. Under its United Behavioral Health unit, UnitedHealth denied care to patients, with one patient dying after he was forced to leave treatment when the insurance company denied payment. U.S. Chief Magistrate Judge Joseph C. Spero, in his 106‐page decision issued March 5, described the company's guidelines as “unreasonable and an abuse of discretion” and having been “infected” by financial incentives meant to restrict access to care. “There is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members' underlying conditions,” he said, dismissing UnitedHealth's testimony as “evasive — and even deceptive.” D. Brian Hufford, who has been taking these parity issues on for years (see ADAW , Sept. 28, 2015, May 6, 2013, April 8, 2013), called the decision “a monumental win for mental health and substance abuse patients.” Hufford is an attorney with Zuckerman Spaeder, who, along with Psych‐Appeal, a private law firm specializing in insurance coverage for mental health issues, is representing the plaintiffs, who are part of a class action lawsuit against United Behavioral Health. For its part, UnitedHealth told the Times it would fight the ruling, which is based on the Mental Health Parity and Addiction Equity Act of 2008. The policies of UnitedHealth appear to be based on initial stabilization of crises only, with no ongoing care or treatment for underlying conditions.