UnitedHealthcare says cancer case that judge recused himself from is flawed

UnitedHealthcare filed a motion to dismiss the amended complaint from a man whose allegations led a federal judge to recuse himself from the case, according to recent court documents.

The plaintiff, Richard Cole, was diagnosed with prostate cancer in April 2018. UnitedHealthcare refused to cover proton beam radiation therapy to treat his tumors, spurring Mr. Cole to file a putative class-action complaint against UnitedHealthcare on April 3. U.S. District Judge Robert Scola, who survived prostate cancer, recused himself from Richard Cole v. United Healthcare Insurance Co. in the Southern District of Florida April 29.

In a motion filed in the Southern District July 8, UnitedHealthcare argued Mr. Cole's allegations were flawed and urged a new federal judge in Florida to pare down the class-action lawsuit. Specifically, UnitedHealthcare requested the court cut three claims Mr. Cole made in his argument that the health insurer violated the Employee Retirement Income Security Act.

UnitedHealthcare said Mr. Cole's "claims ignore a number of important ERISA pleading requirements."

The recused judge, Mr. Scola — who ultimately treated his cancer with surgery — said he could not rule on the case "fairly and impartially" due to the life-saving option proton radiation gave him. At the time of his recusal, Mr. Scola said, "To deny a patient this treatment, if it is available, is immoral and barbaric."

In an April 29 statement to BenefitsPRO, UnitedHealthcare spokesperson Maria Gordon Shydlo said the insurer "bases its medical policies and coverage decisions — including for proton beam therapy — on the prevailing published clinical and scientific evidence."

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