Financial incentives lead to United Behavioral Health’s breach of fiduciary duties

On Tuesday, March 5, Judge Joseph Spero of the U.S. District Court of Northern California issued a ruling in favor of the members of a class-action lawsuit filed against United Behavioral Health (UBH), a subsidiary of Minnetonka-based United Health Group, in 2014.

Spero found that UBH breached its fiduciary duties in deviating from accepted standards of care in creating and applying their coverage-determination guidelines. These guidelines, developed in 2010 in response to the federal parity law, placed an excessive emphasis on addressing acute symptoms, rather than providing treatment for underlying conditions. Spero also found that UBH failed to address effective treatment, pushed patients to lower levels of care, and failed to address differing needs of children and adolescents. These guidelines contained excessive requirements that provided for narrower coverage and were tainted by UBH’s financial interests, which goes against the fiduciary duty owned by UBH to the plan members.

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Originally published at: http://www.startribune.com/judge-calls-unitedhealth-coverage-
guidelines-tainted/506790982/SSS