United Behavioral Wins Appeal Over Mental Health Coverage

United Behavioral Health’s appeal of decisions forcing it to reprocess thousands of claims for mental health coverage succeeded Tuesday, when the Ninth Circuit ruled that the UnitedHealth subsidiary adequately followed plan terms when it denied the challenged claims.

United’s denials were based on an interpretation of plan terms that was “not unreasonable,” the U.S. Court of Appeals for the Ninth Circuit said. The relevant plans exclude coverage for treatments that are inconsistent with generally accepted standards of care, but plan participants failed to show that the plans mandate coverage for all treatments that are consistent with these standards, the court ...