Psych-Appeal Files Suit Against UBH for Denying Standard Behavioral Therapy to Teen With Autism

Psych-Appeal today filed a class-action complaint against insurance giant United Behavioral Health (UBH) on behalf of the mother of a teenager who was wrongfully denied behavioral health therapy for autism. The complaint alleges that UBH’s denial of coverage for Applied Behavioral Analysis (ABA) therapy, which is a generally accepted standard of care for children with autism, violates the Mental Health Parity and Addiction Equity Act of 2008, and is therefore illegal.

The complaint details how the plaintiff’s 13-year-old son was repeatedly denied ABA therapy for his autism spectrum disorder despite numerous recommendations by his mental health care team that he receive such care. ABA therapy is proven as an effective treatment for autism in children and adolescents, especially when it is applied intensely for up to 40 hours per week. In this case, the teenage son had severe difficulty interacting with people and his aggressive and violent outbursts created an unsafe environment for both himself and his mother. Nor could the mother afford to pay out of pocket for extensive treatment, including this therapy.

“UBH’s policy for ABA therapy coverage is a classic double standard,” said Meiram Bendat, founder of Psych-Appeal and co-counsel for the plaintiff. “While UBH recognizes the clinical significance of this therapy and covers it for members of fully-insured plans. Yet, at the same time, UBH enforces coverage exclusions of ABA therapy in its self-funded plans. This paradox highlights the selective adherence to mental health parity laws.”

Doe v. United Behavioral Health was filed in the U.S. District Court for the Northern District of California. The plaintiff is represented by Psych-Appeal and Zuckerman Spaeder LLP.