Earlier this month US Chief Magistrate Judge Joseph Spero issued his decision against United Behavioral Health, a unit of UnitedHealthcare for creating internal policies that effectively discriminated against those seeking mental health and substance abuse treatment. Judge Spero also criticized the Company’s medical directors for being “deceptive” under oath. UnitedHealthcare illegally denied treatment for thousands of people.
Judge Spero stated, “It is well-established that effective treatment of mental health and substance abuse disorders includes treatment aimed at preventing relapse or deterioration of the patient’s condition and maintaining the patient’s level of functioning. UnitedHealthcare guidelines deviate from that standard.” The class-action suit was brought on behalf of more than 50,000 individuals, who were denied coverage by United Behavioral Health. UBH happens to be the country’s largest managed behavioral health care organization.
Spero took more than a year to issue his 106-page decision. He found that United Behavioral Health violated state laws in Illinois, Connecticut, Rhode Island and Texas. UBH was making decisions influenced by their monetary concerns and what profit they could make. UBH knowingly and purposefully drafted their benefit guidelines to limit coverage to acute signs and symptoms.
Plaintiffs Attorney Brian Hufford made it clear that this case involved coverage of benefits for the most vulnerable population, individuals who suffer from mental health disorders and substance abuse. He also expressed that historically insurance companies have successfully been able to hide their conduct and save money by denying treatment to these individuals. UBH claims that its members received proper care for mental health conditions and substance abuse.
The National Alliance on Mental Illness (NAMI) was taken back by Judge Spero’s decision and found the ruling “scathing and breathtaking.” NAMI hopes this decision will help people understand that for decades health insurance companies have discriminated against individuals with mental health conditions. NAMI says that this decision is imperative, especially at a time when life expectancy in America is declining due to “public health crisis in mental health and addiction.”
Legal observers call this decision one of the most significant and most thorough rulings ever issued against an insurance company, at the federal level, on mental health issues