Reuters (8/21, Pierson) reports that the 2nd US Circuit Court of Appeals has ruled unanimously that the New York State Psychiatric Association has standing to sue UnitedHealth Group for treating mental health claims differently than other health claims and claims administrators may be liable for coverage decisions under the Employee Retirement Income Security Act (ERISA).
Modern Healthcare (8/21, Schencker, Subscription Publication) reported that in an Aug. 20 ruling, “a panel of judges for the 2nd US Court of Appeals decided…that UnitedHealth Group, as a third-party administrator for an employee health plan, is not exempt from ERISA, which regulates traditional pensions and other employer-provided benefits.” The panel also ruled that “under ERISA, the administrator must follow the mental health parity law.” The ruling may “lead to more patients and [healthcare professionals] challenging plan administrators who try to limit access to mental health services, some say.”
Related Links:
— “Psychiatric group’s ERISA case against UnitedHealth revived,” Brendan Pierson, Reuters, August 21, 2015.