New York State Psychiatric Association Files Suit Against UnitedHealth

March 12, 2013

The New York State Psychiatric Association and consumers with health insurance from UnitedHealth Group Inc on Monday sued the company over mental health benefits, saying it had not provided the treatments that federal and state laws require.

The suit, which seeks class action status on behalf of the psychiatric association’s members and other health insurance customers, seeks to compel UnitedHealth to comply with the law and cover mental healthcare and seek financial losses.

UnitedHealth is the nation’s largest health insurance company. A spokesman did not have an immediate comment.

The New York State Psychiatric Association, the New York division of the American Psychiatric Association, said in the suit it had received many complaints about UnitedHealth’s policies that eliminate, reduce and discourage mental healthcare.

It said that it requires strict medical criteria and preauthorizations that it does not place on primary medical care, whereas the law requires parity. The suit says the company violates the Federal Parity act, ERISA rules, the Affordable Care Act, New York state laws, and other laws.

The National Institute of Mental Health estimates that 5 percent of Americans have a serious mental illness, while an estimated 26 percent of Americans ages 18 and older – about one in four adults – suffer from a diagnosable mental disorder in a given year.

As these numbers show, the majority of mental illnesses are mild to moderate, such as moderate depression or anxiety, rather than severe, such as schizophrenia or psychosis.

In 2006, the last year for which complete data are available, 36.2 million people paid for mental health treatment, for a total expenditure of $57.5 billion. Of those 4.6 million were children, whose mental health services cost $8.9 billion.

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