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Diana L. Courson

Zuckerman Spaeder LLP Files Class Action Lawsuit Against Health Insurers Denying Mental Health Coverage

May 27, 2014

Zuckerman Spaeder LLP joined Psych-Appeal Inc. and The Maul Firm, P.C., in filing a federal class action lawsuit against UnitedHealthcare Insurance Company and United Behavioral Health (operating as OptumHealth Behavioral Solutions) on behalf of a class of claimants affected by mental health conditions or substance abuse disorders. New York-based Zuckerman Spaeder partners D. Brian Hufford and Jason S. Cowart collaborated on the complaint, which was filed on May 21, 2014, in the U.S. District Court for the Northern District of California in San Francisco.

The lawsuit details violations of the Mental Health Parity and Addiction Equity Act (Federal Parity Act) and the Employee Retirement Income Security Act (ERISA). It highlights the insurers’ routine denial of coverage for treatment of mental illnesses and substance abuse based upon overly restrictive internal policies and practices that are inconsistent with nationally recognized scientific evidence, medical standards, and clinical guidelines. Challenged in the complaint are a number of internal policies and interpretations that highlight the defendants’ significant discrimination against patients seeking coverage of treatment for mental health or substance abuse conditions.

“Both individual care and our health system at large suffer when private health insurers ignore the law and impose restrictive, biased policies upon select groups of patients,” said Mr. Hufford. “With this lawsuit, we are seeking to uphold legal requirements that mental health conditions and substance abuse disorders are treated consistent with the treatment of other medical conditions.”

Mr. Hufford and Mr. Cowart have developed a national practice representing patients and health care providers such as doctors, hospitals, and medical equipment companies in disputes with health insurance companies. They recently published an article in National Law Journal in which they analyze the history of advocacy and legislation aimed at making mental health care more accessible and provided on equal terms with physical health care.