Landmark Federal Court Ruling on Mental Health
On March 5, the United States District Court for the Northern District of California held that United Behavioral Health (UBH), the country’s largest managed behavioral healthcare organization, illegally denied mental health and substance use coverage based on flawed medical necessity criteria.
After weeks of testimony and reams of documents, U.S. Chief Magistrate Judge Joseph C. Spero found that UBH had created internal policies aimed at effectively discriminating against patients with mental health and substance abuse disorders in order to save money.
The Judge’s findings reinforce what NAMI members have experienced for decades. Even with parity laws, people with mental health conditions too often find that, even if their plan “covers” mental health services, they are denied the most appropriate and effective treatment.
While this is just a first step, NAMI views this as a monumental win for people with mental health conditions. We are hopeful that these findings will have an impact on how plans make medical necessity determinations for people with mental health conditions. As Angela Kimball, National Director of Advocacy and Public Policy, told The New York Times, “This should put health plans on notice that they simply can’t make up the rules as they go along.”
This important decision, paired with last week’s Zero Discrimination Day (which occurred on March 1), provides another opportunity to call for an end to discrimination against covering mental health treatment. We urge you to continue to call on elected officials in your state to fulfill the promise of equal treatment under the law with greater enforcement of the federal parity law.