UnitedHealthcare slammed for violations of federal and Texas law
A federal judge in Northern California released a 106 page decision Tuesday which held that UnitedHealthcare fraudulently created guidelines that denied benefits to its members solely to save money. The court found that United’s mental health subsidiary had used self-serving guidelines to justify the denials of badly needed mental health treatment for over six years. The guidelines conflicted with generally accepted medical standards as well as federal and state law, including our statutes in Texas. The story sounds like it came from a John Grisham novel like The Rainmaker.
Judge Joseph Spero wrote that the primary factor in the development of internal company guidelines was the maximization of profit, not adopting generally accepted medical practices. The provider had focused on its ‘bottom line as much or more” than the health of its policyholders and had illegally denied badly needed treatment to thousands of them.