“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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Ross Todd
Ross Todd is the Editor/columnist for the Am Law Litigation Daily. He writes about litigation of all sorts. Previously, Ross was the Bureau Chief of The Recorder, ALM's California affiliate. Contact Ross at [email protected]. On Twitter: @Ross_Todd.
