UnitedHealth ordered to reprocess 67,000 mental health claims

UnitedHealth Group must redo 67,000 medical claims for behavioral healthcare that it previously denied, a federal judge ordered Nov. 4. 

Advertisement

The order comes after a March 2019 ruling from Judge Joseph Spero of the U.S. District Court of Northern California. He ruled that a UnitedHealth unit instituted guidelines that denied care to patients needing mental health treatment to cut costs.

In his March 2019 ruling, Mr. Spero said UnitedHealth’s internal policies for mental health coverage were “unreasonable and an abuse of discretion” and “infected” by financial incentives, according to The New York Times.

In a statement to the Star Tribune, UnitedHealth said it is reviewing the order and considering options, including an appeal. 

“Over the last several years, we have taken concrete steps to improve access to quality care by enhancing coverage through clinician-developed evidence-based guidelines, expanding our network of providers and providing new ways for people to quickly access care. We are focused on ensuring our members get the quality, compassionate care they need, and will continue working closely with people across the behavioral health community on this important issue,” the statement reads, according to the Star Tribune.

More articles on payers:
500+ BCBS of Michigan employees take buyouts
CMS issues coverage rules for COVID-19 vaccine: 10 things to know
BCBS of Illinois to pay hospitals $100M to improve health equity

Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.