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United Healthcare Fights Prosthesis Coverage Class Action

March 5, 2019, 8:41 PM

United Healthcare Services Inc. defended itself from a class action by more than 1,000 patients who say the insurer wrongly denied coverage for their prosthetic devices.

The insurer’s health plans give it “sole and exclusive discretion” to make decisions about what to cover, United said in its March 4 motion for summary judgment. The coverage denials are therefore subject to deference from the courts and can’t be overturned unless there’s “no reasonable basis” for the decision, the insurer argued.

United also defended its claim review procedures, which allegedly involved three levels of independent physician review for each coverage request.

The...

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