May 13th, 2019

The shame of United Behavioral Healthcare

United Behavioral HealthI’m surprised United Behavioral Healthcare (UBH) – a part of behemoth UnitedHealthcare — can even show its face these days. After a scathing ruling against this disliked healthcare insurer was handed down in early March, it’s become clear – to me at least — that UBH only cared for its bottom line, not the highest quality patient care possible.

It also once again illustrated the separate and unequal systems that exist in parallel – one that treats physical symptoms, and an inferior system setup to provide the most minimal of coverage to treat mental symptoms.

In the case, Wit v. United Behavioral Health, the judge found in 106-page decision that UBH denied the claims of tens of thousands of people in northern California based on defective, and sometimes arbitrary, medical review criteria.

UBH guidelines specifically deviated from the standard level of care expected to treat mental health and substance use disorders. To anyone who’s ever had to deal with getting UBH approval for continued care, this situation surprised few.

The judge also demonstrated how UBH’s efforts circumvented the protections of the 2008 Mental Health Parity and Addiction Equity Act.

UBH seemed to have consistently failed to provide coverage when medically necessary, and made apparently arbitrary distinctions of when coverage could be applied between acute and chronic episodes of mental illness.

UBH also overruled patients’ own clinicians and therapists when the recommended level of care was higher (e.g., more expensive) than what UBH thought was needed.

The insurance company used guidelines developed with an apparent emphasis on monetary concerns over actual treatment standards.

UBH also apparently ignored state rules, such as those found in Connecticut and Rhode Island, about what type of review to conduct for substance use disorder claims.

UBH appears to have taken advantage of the lack of enforcement and transparency in mental illness insurance coverage in order to drive profits ahead of patient care. Instead of being a core support for a patient’s care and recovery from a mental illness, it looks like UBH became a mental jailer of patients, sometimes denying them the treatment that would help them in their road to recovery.

Insurance companies are supposed to be your partner in care, providing the financial resources and backing to cover health and mental health issues as they arise in life.

When a company such as UBH violates the trust of this relationship, it is a black mark on its integrity. And it’s a stark reminder that even an insurance company will take advantage of those most vulnerable and in need.

By John Grohol, Psy.D.

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