Recent District Court Decision Highlights the Importance of Adequate Behavioral Health Claims Processing Guidelines for ERISA Plans

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Manage episode 279835531 series 1533910
By K&L Gates and L Gates. Discovered by Player FM and our community — copyright is owned by the publisher, not Player FM, and audio is streamed directly from their servers. Hit the Subscribe button to track updates in Player FM, or paste the feed URL into other podcast apps.

On this week’s episode, Carla DewBerry and Sarah Carlins discuss a recent California Federal District Court decision in David Wit v. United Behavioral Health, in which the court found that the defendant insurer violated ERISA by improperly denying behavioral health claims submitted by over fifty thousand beneficiaries. The presenters discuss the ways in which the insurer’s inadequate internal guidelines for the processing of behavioral health treatment claims led to the decision, and what this might mean for the design of behavioral health claims processing guidelines under ERISA regulated health plans in the future.

143 episodes