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United Healthcare Mental Health Coverage Class Action Lawsuit
By Mike Holter
A class action lawsuit claims United Behavioral Health, a unit of United Healthcare Insurance Company, unlawfully denies mental health coverage to policyholders.
According to the class action lawsuit, United Behavioral Health violated California’s Mental Health Parity Act, which requires insurers to provide treatment for mental-health diagnosis according to “the same terms and conditions” applied to medical conditions. Specifically, the insurer is accused of denying and improperly limiting mental health coverage by conducting concurrent and prospective reviews of routine outpatient mental health treatments when no such reviews are conducted for routine outpatient treatments for other medical conditions.
The United Healthcare class action lawsuit further charges the company with violating the Unruh Act by discriminating against people with mental disabilities and psychiatric conditions, as well as violating California’s law prohibiting unfair competition, breaching the terms of its own insurance contract with policyholders, and breaching the implied covenant of good faith and fair dealing.
“This is an important case because it addresses an issue that impacts a wide range of people who are covered by health insurance” said the lead attorney representing the Class in the lawsuit. “For too long, people who suffer from severe mental health issues have not received health insurance coverage on the same terms as conditions that are applied to other conditions.”
The lead Plaintiff in the class action lawsuit is a University of California employee who claims her mental health coverage was improperly reduced from four weekly outpatient psychotherapy sessions to only one weekly session for one month.
The lawsuit is seeking to represent a class consisting of hundreds, and possibly thousands, of University of California employees who were subjected to improper review and denial of treatment for severe mental health illnesses.
Updated May 25th, 2012
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17 thoughts onUnited Healthcare Mental Health Coverage Class Action Lawsuit
I would like information for declnes in Texas. My health provider at a treatment facility is saying that Optum told them, in advance of any possible appeal of their currently offered reduced and limited coverage that Optum could decline ALL coverage if the appeal is lost. This seems to put unreasonable pressure they used to prevent appeals.
I work in Idaho and Optum a United subsidiary runs Mental Health services and they contradict their own rules and deny people services here who need them. What gets me is a so called professional from Pennsylvania or any other state can deny someone services in Idaho when they dont even live here let alone been in the state for more than 48 hours. Something needs to be done.
This is happening in every state. United and others audit mental health outpatient service oroviders to recoup payments already made as well as to deny future eligibility OF MENTAL HEALTH ICD9 codes ONLY. This violates ADA. HHS needs to know this. There needs to be a national class action suit. In KS, the state participates in this charade with their other 2 medicaid providers, Sunflower and Amerigroup. Outpatient providers are continuously audited. If they can drive providers out of business, it’s not their fault thete is no one to provide services.
In 1992, Managed Care came to New York; it had begun just a few years earlier in California. In 22 years, it is now the “law of the land” as it applies to medical and mental health treatment. Its main job? To save money for the insurance company. Unfortunately, for patients who are in desperate need of good quality care, some Managed Care companies play the obstructionistic card, i.e., the more hoops and hurdles they place in the way of a patient, it is hoped the patient will just, well…..give up, die, or just go away. If they succeed in thwarting the patient, then treatment doesn’t happen, and the insurance company saves money. Or do they? Well, they still have to pay the Managed Care company – and that’s where the smoke and mirrors comes in, isn’t it? This sick process will only succeed, eventually, in creating enough pushback that a single payer system will be the only logical result – maybe not such a bad thing..
I am a mental health provider. I am currently required to participate in the UBH clinical review process for clients with their coverage. This would seem to imply that I am participating in a criminal act! Any redress for providers like me?
My son is being denied behavioral therapy in the state of texas due to the value options portion of united healthcare! I am in desperate need of getting some sort of advice on trying to get this fixed or something, this sounds like what is happening here. How do I get more information?