Insurance Update

Class Action against United Behavioral Health

October, 2016

 The United States District Court for the Northern District of California has certified a nationwide Employee Retirement Income Security Act (“ERISA”) class action in a case pending against the country's largest managed behavioral health care organization, United Behavioral Health ("UBH"). ERISA is the federal law that governs self-funded plans by large employers and groups of smaller employers. The main contention in the case is that UBH uses restrictive medical necessity guidelines to deny claims for behavioral health. The plaintiffs allege that UBH's interests in profitability have led it to develop medical necessity criteria that overemphasize acute symptoms to the exclusion of meaningful treatment for chronic and pervasive mental health and substance use disorders. The outcome should have an impact on all forms of commercial insurance. CAMFT will keep members apprised of the status of the case.