Update: UnitedHealth Group Psychotherapy Reimbursement Suit Moves Ahead

A federal judge has ruled that a lawsuit alleging that Oxford Health Insurance (“Oxford”), owned by UnitedHealthcare Insurance Company and UnitedHealth Group, applies discriminatory reimbursement policies for psychotherapy rendered by psychologists and master’s level clinicians will proceed.

U.S. District Judge Ann M. Donnelly said Monday that the class-action complaint, filed by Psych-Appeal and Zuckerman Spaeder LLP, sufficiently alleged that Oxford imposed arbitrary reimbursement penalties on psychotherapy.

The plaintiffs allege that Oxford reimburses out-of-network psychotherapy provided by psychologists and master’s level clinicians at rates 25 percent to 35 percent less than it does for medical doctors, who may not even have specialized mental health training. The plaintiffs argue that Oxford’s reimbursement policy artificially devalues psychotherapy and restricts access to this essential health benefit, and that it violates the Federal Parity Act and the Affordable Care Act.

“There is no similar treatment restriction for medical/surgical healthcare benefits,” said Judge Donnelly in her order.

Doe v. UnitedHealth Group Inc. et al was filed in the U.S. District Court for the Eastern District of New York.

Previous news: UnitedHealth Group Complaint Filed Alleging Violation of Parity Laws for Psychotherapy Services

 

Related coverage: Oxford Can’t Duck Claims In Psychotherapy Benefits Suit, Law360, August 22, 2018 (NOTE: This link is available to Law360 subscribers.)