UnitedHealth Group must reprocess about 67,000 behavioral health care claims that it previously denied, a federal judge ordered on Nov. 3.
The ruling comes after a years-long legal battle, which is centered around more than 50,000 patients who were beneficiaries of UnitedHealthcare’s United Behavioral Health (UBH) between 2011 and 2016. During that time, their behavioral health treatments were unfairly denied, the plaintiffs claim.
This is the second time a judge has ruled against Minnetonka, Minnesota-based UnitedHealth. Back in 2019, a federal judge ruled that UnitedHealth’s behavioral health division used coverage guidelines that were too restrictive.
Rather than to help patients, UBH’s guidelines were meant “to protect its bottom line,” Judge Joseph Spero wrote in his Nov. 3 ruilding.
Reprocessing the claims should take about a year, the plaintiffs attorney Caroline Reynolds of Zuckerman Spaeder LLP told the Star Tribune. The court will appoint a special master to oversee the process, which Reynolds says she’s confident will lead to a lot of people “getting a different decision this time around.”
Meanwhile, UnitedHealth Group told the Star Tribune that it’s reviewing the order and weighing its options, which could include an appeal.