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United loses in court on behavioral health coverage rules
Modern Healthcare

A federal judge ruled Tuesday that United Behavioral Health breached its fiduciary duty to patients by using unreasonable and overly restrictive guidelines to make coverage decisions for tens of thousands of mental health and substance abuse patients.

The decision, if upheld on appeal, could have wide ramifications of what insurers must cover in the fast-growing behavioral healthcare sector.

The case stems from two consolidated class-action lawsuits filed in 2014 against UnitedHealth Group’s United Behavioral Health, the nation’s largest behavioral health insurer. It went to trial in October 2017 before U.S. Chief Magistrate Judge Joseph Spero in San Francisco.