Psych-Appeal Inc. Files Lawsuit Against UnitedHealthcare for Allegedly Denying Mental Health Benefits
Nationwide Class Action Among the First of Its Kind; Alleges Violations of ERISA
Psych-Appeal Inc., in conjunction with Zuckerman Spaeder LLP and The Maul Firm, P.C., has filed a nationwide class-action lawsuit against UnitedHealthcare Insurance Company and United Behavioral Health (doing business as OptumHealth Behavioral Solutions) on behalf of mental health and substance abuse claimants. The federal lawsuit cites violations of the Employee Retirement Income Security Act (ERISA) and the Mental Health Parity and Addiction Equity Act.
The complaint was filed on May 21, 2014, in the U.S. District Court, Northern District of California. It alleges the defendants’ misuse of hospitalization criteria to deny non-hospital levels of care, failure to abide by generally accepted medical guidelines, the application of discriminatory evidentiary standards, and categorical refusal to pay for nutritional counseling.
“UnitedHealthcare’s motives are clear,” said Meiram Bendat, mental health attorney and founder of Psych-Appeal, Inc. “As one of the country’s largest health insurers, UnitedHealthcare is denying medically necessary benefits to save on costs that are often associated with the treatment of chronic mental health conditions.”
The lawsuit was brought by a family in New York whose teenage daughter required residential treatment for depression and an eating disorder, as well as by an adult male in Illinois who struggled with alcoholism and was denied admission for residential treatment. Despite the treating facilities’ recommendations for care, UnitedHealthcare relied on improper protocols to deny it, allege the plaintiffs.
“Insurers who don’t abide by generally prevailing medical standards flagrantly jeopardize the health and safety of their members,” said Brian Hufford, partner at Zuckerman Spaeder LLP. “If health insurance policies provide for mental health and substance abuse treatment, patients should have appropriate access to that care.”
According to the National Institute of Mental Health, approximately one in four Americans suffer from a mental health condition each year, making mental health and substance abuse disorders among the leading causes of disability in the United States. Mental health parity laws and the Affordable Care Act have sought to address this issue by placing mental health treatment on par with medical care.