In a scathing decision –
March 5, 2019 – U.S. Chief Magistrate Judge Joseph C. Spero found that United Behavioral Health, the insurer’s unit that administers treatments for mental illness and addiction in private health plans, had violated its fiduciary duty under federal law. In his 106-page decision, Judge Spero described the company’s guidelines as “unreasonable and an abuse of discretion” and having been “infected” by financial incentives meant to restrict access to care.
“There is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members’ underlying conditions,” he said. He dismissed much of the testimony by UnitedHealth’s experts as “evasive — and even deceptive.”