Psychiatric News (5/20) reports, “Managed care organizations must use medical necessity criteria and assessment tools developed by nonprofit mental health and substance use disorder specialty organizations when making coverage-related determinations,” was what the American Psychiatric Association (APA) and “seven other medical organizations told the United States Court of Appeals for the Ninth Circuit in a friend-of-the-court brief [PDF] filed yesterday in the case David Wit, et. al., v. United Behavioral Health (UBH).” That “brief is informed by a 2020 APA Position Statement on Level of Care Criteria for Acute Psychiatric Treatment.” In a press release, APA President Vivian Pender, MD, stated, “Standards of care should be based on the best treatment for patients, not the bottom line.” APA CEO and Medical Director Saul Levin, MD, MPA, said, “APA calls upon courts, legislatures, and insurance commissioners to require insurance companies to deliver the care for which patients and employers have paid based upon evidence-based, objective, and patient-centered guidelines, rather than company profits.”
Related Links:
— “Court Ruling in Wit v. UBH Should be Upheld, Urges APA, Psychiatric News, May 20, 2021