A group of UnitedHealth members are filing an appeal to a recent court case against the company regarding its mental healthcare coverage practices. The class-action lawsuit alleged that United was basing its coverage decisions on patient claims based on the whims of the finance department, ignoring medical needs. The patient group had orgininally won their case in 2019 and 2020, but these wins were undone by court reversal last year.
According to Jakob Emerson, “In March 2022, the 9th Circuit Court of Appeals reversed the district court’s decisions. Several states, the American Hospital Association, American Psychological Association and others sided with the plaintiffs and appealed the decision in May 2022. In January 2023, the 9th Circuit issued a new ruling that partly ruled in favor of the plaintiffs by saying that some members saw a breach of fiduciary duty from UBH, but it did not order claims to be reprocessed nor halt UBH from using its internal guidelines, according to Law360.”
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(Source: Becker’s Payer Issues, March 14th, 2023)