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Employee mental health is becoming an important issue for employers, and one of the ways to help workers is through their employee benefits packages. Here we look at trends, build awareness, and share ideas for benefits managers and brokers.

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UnitedHealth's mental health coverage guidelines overly restrictive, judge rules

The policies over-emphasized cost-savings and addressing acute problems rather than treating underlying mental health and substance abuse issues.

By Ross Todd | March 06, 2019 at 11:02 AM
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U.S. Magistrate Judge Joseph Spero, Northern District of California “There is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members’ underlying conditions,” wrote U.S. Magistrate Judge Joseph Spero. (Photo: Jason Doiy/ALM)

A federal judge in San Francisco has found that an affiliate of UnitedHealthcare, the nation’s largest health insurer, breached its fiduciary duty to policyholders by following guidelines that emphasized cost-savings and addressing acute problems rather than treating underlying mental health and substance abuse issues.

U.S. Magistrate Judge Joseph Spero of the Northern District of California issued a 106-page ruling Tuesday finding that the guidelines that United Behavioral Health used when making coverage decisions in cases of mental illness and substance abuse didn’t provide for generally accepted standards of care outlined in the plaintiffs’ policies.

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