On Tuesday, an Employee Retirement Income Security Act (ERISA) plan beneficiary on behalf of their minor child filed a complaint in the District Court of Utah against United Health Care and it’s mental health subsidiary United Behavioral Health. The case claimed improper processing of mental health related treatment under the plaintiffs’ ERISA health plan.
The complaint explained that the minor patient had a long psychiatric history including violent aggressive behavior, self harm, anxiety, and inappropriate behavior. When the patient’s condition escalated to suicidal behavior, the minor’s parents sought a residential treatment position to provide the maximum amount of assistance.
The treatment was performed at Turn About Ranch, which is licensed for residential treatment. United Behavioral Health, however, denied the treatment, stating that even though Turn About Ranch was licensed by the state for residential treatment, that it did not consider the treatment to be medically necessary.
The plaintiff appealed the denials, arguing that ERISA plans require a higher standard of scrutiny as to medical necessity. The plaintiff also argued that the Mental Health Parity and Addiction Equity Act requires that the standard applied to mental health treatment not exceed that applied to medical treatment. The defendant maintained the denials, leading the plaintiffs to seek aid through the court.
The plaintiff is suing for recovery of benefits and violation of the Mental Health Parity and Addiction Equity Act. The plaintiff is represented by Brian S King P.C.