A federal judge in a class action suit says UnitedHealth Group wrongly refused to pay mental health treatment costs for tens of thousands of customers in order to protect its bottom line. Here are some of the patients' stories: (via MPRnews)
Their son had struggled for years with mental health problems and substance use, products of a violent hit during a junior year high school football practice that left him with a concussion and neck injury so bad he couldn't play anymore.
His story is now part of a class action lawsuit that may include as many as 50,000 people challenging UnitedHealth's standards for behavioral care. U.S. Chief Magistrate Judge Joseph C. Spero recently ripped the Twin Cities-based insurer for placing an"excessive emphasis" on paying for treatments during a crisis while ignoring"effective treatment of ... underlying conditions.
Huskamp compares UnitedHealth's behavioral health standard to an insurer covering only an emergency in diabetes, but not long-term management of the disease. They'll cover the crisis, she said, but"when [the patient comes] home, you're not going to cover their insulin or their routine care like their diabetic eye exams or the other kinds of care they need to stay healthy."
Chuck Lesniak of Austin, Texas, said his middle-school daughter developed severe anorexia five or six years ago to the point where she was nearly passing out every time she stood up,"just eating very very small amounts and it became very bad, very very quickly." "They just basically said no, you're done," Lesniak recalled."You've exhausted your appeals and there's nothing you can do. That's your debt and your problem."
They let her go away to college after high school, thinking it would offer a fresh start. She had barely started her first semester when her parents got a call that she was in the hospital after trying to kill herself.She started seeing her longtime psychologist again. Shortly after, her doctor urged the family to get Katie into a residential treatment facility.
Gruman kept her kidney. She and her husband used credit cards and borrowed money from family and their retirement accounts. "Our argument would be that United has to adopt new guidelines that satisfy generally accepted standards of care," said one of the attorneys, D. Brian Hufford."That it should improve and change its processes for reviewing and adopting and applying guidelines."The Tillitts say they ended up spending more than $100,000 for Max's care.
"It used to make me so mad," DeeDee recalled, laughing, as she sat in her office recently where she works as part of the health insurance industry."Like, 'Max, I don't want to save everybody, I just want to save you.' And he was just like, 'Oh, Mom, come on, we have to help out so and so.'"
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