UnitedHealthcare under fire for allegedly denying mental health coverage

A federal class action lawsuit alleging the denial of mental health and substance abuse coverage has been filed against UnitedHealthcare and United Behavioral Health (operating as OptumHealth Behavioral Solutions). 

The lawsuit details violations of the Mental Health Parity and Addiction Equity Act (Federal Parity Act) and the Employee Retirement Income Security Act (ERISA) and focuses on restrictive internal policies and practices deemed inconsistent with nationally recognized medical standards and clinical guidelines. 

According to Bloomberg BNA, the complaint was filed in the U.S. District Court for the Northern District of California. It seeks class treatment for three proposed classes of health plan participants and beneficiaries who were denied coverage for nutritional counseling or for residential treatment for mental health or substance use disorders.

“Mental health and/or substance abuse treatment is costly and ongoing, says Carolyn Wolf, executive partner in the law firm Abrams, Fensterman, Fensterman, Eisman, Formato, Ferrara & Wolf, LLP and director of the firm’s mental health law practice. “What health plans must consider is that intervention and treatment is ultimately less costly than an eventual inpatient hospitalization for a sicker and more symptomatic individual who will take longer and require more resources to stabilize.”