UnitedHealth Group faces a lawsuit that accuses the health insurer of illegally denying mental health and addiction benefits to maximize profits.
The class-action lawsuit, filed Sept. 12 by law firm Napoli Shkolnik on behalf of three mental health and addiction treatment facilities, claims the treatment centers provided millions of dollars in unreimbursed care to members of UnitedHealth's behavioral health unit, United Behavioral Health. Specifically, the three plaintiffs allege they had 157 patients with more than 2,000 claims that were illegally denied by United Behavioral Health. The plaintiffs said the amount of denied claims for them alone totals $5 million, while denied claims for the entire class could exceed $9.3 billion.
The latest lawsuit cites a previous decision handed to UnitedHealth concerning mental health claims. In March, U.S. Chief Magistrate Judge Joseph Spero ruled that UnitedHealth instituted guidelines that denied care to patients needing mental health treatment to cut costs and breached its federal fiduciary duty to plan members.
In an emailed statement to Becker's, a UnitedHealth spokesperson said the health insurer disagrees with the allegations in Napoli Shkolnik's lawsuit and plans to fight the litigation.
"We strive to ensure that health plan members have access to a network of evidence-informed care that has been shown to be most effective in helping people overcome and live better with behavioral health and substance abuse conditions, consistent with the terms of their individual health plans," the spokesperson said.
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