ABHW files amicus brief in Wit v. United Behavioral Health

The Association for Behavioral Health and Wellness (ABHW), the national voice for payers that manage behavioral health insurance benefits for over 200 million people, on April 14 submitted an amicus curiae brief in support of United Behavioral Health in Wit v. United Behavioral Health , which is on appeal in the U.S. Court of Appeals for the Ninth Circuit. The brief focuses on the rigorous process by which plans develop clinical guidelines and the central role of those guidelines in plans' management of member benefits. According to an excerpt from the brief, “Clinical guidelines health plans use to determine coverage and benefits are the products of rigorous processes that aim to balance numerous considerations: safeguarding the goal that plan members receive the treatment most appropriate for their condition, achieving consistency with generally accepted medical standards, and enabling the plan to manage benefits.” The brief also indicated, “It is not a court's role to condemn evidence‐based clinical guidelines that a plan has chosen to apply under its own contracts — even if the court or a party's paid experts believe different standards are better or conclude the plan should have weighed the relevant considerations differently.”