UnitedHealth subsidiary must pay $20M after purposely denying claims to ‘protect its bottom line’

A subsidiary of UnitedHealth Group has been ordered to pay more than $20 million for wrongly denying mental health coverage claims, a California court ruled recently.

United Behavioral Health owes $19.6 million in fees and $1.2 million in court costs, the U.S. District Court for the Northern District of California said on Jan. 5. The ruling ends a more than six year lawsuit, Bloomberg Law reported Jan. 6.

Back in March 2019, the court determined that UBH’s internal guidelines were misaligned with the terms of member insurance plans and violated the Employee Retirement Income Security Act of 1974. The subsidiary was then ordered to reprocess thousands of improperly denied claims.

Then, in a November 2020 follow-up order, the court found UBH purposely denied claims to “protect its bottom line,” the news outlet reported.

“To conceal its misconduct, UBH lied to state regulators and UBH executives with responsibility for drafting and implementing the guidelines deliberately attempted to mislead the court at trial in this matter,” according to court documents.

Read the full story from Bloomberg below.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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