United Behavioral Health Mostly Keeps Coverage Win in 9th Cir.

A lawsuit accusing United Behavioral Health of using faulty internal guidelines to limit mental health coverage will go back to district court after the Ninth Circuit on Thursday issued a new opinion largely favoring the company.

United’s coverage guidelines don’t conflict with the plain language of its health plan documents, and the federal judge who ruled otherwise improperly substituted his own interpretation instead of deferring to the company, the US Court of Appeals for the Ninth Circuit ruled.

The court also reversed a decision certifying a class of plan participants who seek “reprocessing” of their benefit claims, saying that reprocessing ...