Mental Health Treatment Denied to Customers by Giant Insurer’s Policies, Judge Rules
In a scathing decision released Tuesday, a federal judge in Northern California ruled that a unit of UnitedHealth Group, the giant health insurer, had created internal policies aimed at effectively discriminating against patients with mental health and substance abuse disorders to save money.
U.S. Chief Magistrate Judge Joseph C. Spero found that United Behavioral Health, the insurer’s unit that administers treatments for mental illness and addiction in private health plans, had violated its fiduciary duty under federal law.
In his 106-page decision, Judge Spero described the company’s guidelines as “unreasonable and an abuse of discretion” and having been “infected” by financial incentives meant to restrict access to care.
“There is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members’ underlying conditions,” he said. He dismissed much of the testimony by UnitedHealth’s experts as “evasive — and even deceptive.” [...]addiction health care finance insurance judicial opinions mental health public health regulation