UnitedHealth fights retroactive claim review in mental health coverage case

UnitedHealth Group is fighting a request to retroactively review claim denials for mental health treatment in an ongoing legal case, according to MPR News.

In March, a judge ruled in favor of a class-action lawsuit accusing a UnitedHealth unit of instituting guidelines that denied care to patients needing mental health treatment to cut costs. In a 106-page ruling, U.S. Chief Magistrate Judge Joseph Spero said that UnitedHealth's internal policies for mental health coverage were "unreasonable and an abuse of discretion" and "infected" by financial incentives.

In the lawsuit, the plaintiffs called on UnitedHealth to adopt new guidelines for behavioral health coverage and to review all claims it denied between 2011 and 2017. UnitedHealth said in its legal response that it has already adopted new standards for substance use disorder treatment and new guidelines for mental health care that will take effect in 2020. However, the insurer rejected a retroactive review of its claim denials.

"We simply believe that in this case, the law simply doesn't allow for some of the proposed remedies and that none of those proposed remedies were adequately presented at the trial," a UnitedHealth spokesperson told MPR News.

A legal reply from the plaintiffs is due in July.

Read more here.

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