Four things to know:
1. U.S. Chief Magistrate Judge Joseph Spero made his decision March 5 in Northern California. He ruled that the insurer’s unit that administers treatment for addiction and mental illness, United Behavioral Health, breached its federal fiduciary duty.
2. In his 106-page ruling, Mr. Spero said that UnitedHealth’s internal policies for mental health coverage are “unreasonable and an abuse of discretion” and that they are “infected” by financial incentives, according to The New York Times.
3. In an emailed statement to the publication, UnitedHealth disagreed with the judge’s ruling. “We look forward to demonstrating in the next phase of this case how our members received appropriate care. We remain committed to providing our members with access to the right care for the treatment of mental health conditions and substance use disorders.”
4. A final judgment is set to come from Mr. Spero in the next few months, according to the report.
More articles on payers:
Oscar Health’s telemedicine use 5 times greater than health insurance average
Older adults drawn to short-term health plans due to cost, survey finds
Breast cancer care delayed for women in high-deductible plans, study finds
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
