A federal appellate court ruled that some beneficiaries of UnitedHealth Group's behavioral health unit may be entitled to have their claims reprocessed, according to an Aug 22 decision.
The decision by the U.S. Court of Appeals for the 9th Circuit partially reverses a ruling it made in March 2022. At that time, the court reversed a lower court's decision that required 67,000 previously denied mental health and substance abuse claims to be reprocessed.
The judges remanded the case back to the U.S. District Court of Northern California, where in 2019 Judge Joseph Spero said UnitedHealth's internal policies for mental health coverage were "unreasonable and an abuse of discretion" and "infected" by financial incentives.
Following the appellate court's 2022 decision, the attorneys general of Connecticut, Rhode Island and Illinois sought to overturn UnitedHealth's win, arguing the court's ruling set a "dangerous precedent for how [addiction] treatment can be covered nationwide."