UnitedHealth Group avoided a parity fight Monday, when a California federal judge dismissed a lawsuit claiming the insurer unfairly denied a man his right to receive coverage for addiction treatment. However, the insurer isn’t in the clear just yet, according to Law 360.
The class action suit, originally filed last July, stated that the lead plaintiff, identified as Ryan S., was a recovering heroin user who was a dependent beneficiary of his father’s UnitedHealthcare coverage.
Ryan S. claimed he initially sought treatment at an out-of-network Southern California facility for recurring drug issues, starting in 2016. According to his lawyers, he was entitled to coverage for treatment under guidelines of the Mental Health Parity Act of 2008, originally designed to prevent most insurers from providing more restrictive coverage for mental health and substance use disorders (SUD) than for medical and surgical services.
Additionally, Ryan S.’s team contended that the Affordable Care Act guaranteed their client’s right to be given sufficient mental health and SUD services by UnitedHealth.
In court documents, Ryan S. listed seven instances of UnitedHealth violating his rights. However, the judge said that there were issues with the plaintiff’s first amended complaint. Specifically, it failed to allege UnitedHealth denied him coverage for his treatments. Additionally, the judge said the brief was not a pleading.
The legal challenge is still not completely over. The judge gave Ryan S. and his team 21 days to amend the complaint in order for it to continue.
“[The judge’s] ruling was well taken; we are going to address the comments by the court when we amend our complaint,” Richard Collins, an attorney for Ryan S., told Law 360. “But certainly this ruling is not a roadblock; we see it merely as a speedbump on our way to trial.”
Over the past several years, UnitedHealth has made headlines for similar parity violation claims.
In fact, last year, a federal judge ruled UnitedHealthcare’s United Behavioral Health used guidelines that were too restrictive in the coverage of thousands of substance abuse patients. The insurer has appealed the ruling.
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