Recent Developments in the United Behavioral Health Surprise Billing Lawsuit
In a recent development in the LD et al v. United Behavioral Health et al case, a California federal judge expressed strong interest in certifying classes of patients who claim United Behavioral Health and billing contractor MultiPlan underpaid thousands of claims for out-of-network substance use disorder treatment. The proposed class includes at least 11,280 patients who participate in employee group health plans administered by United Behavioral Health (UBH) and MultiPlan and who were allegedly underpaid out-of-network reimbursements for intensive outpatient treatment for alcohol use disorder. The judge has yet to issue a ruling on the question of certification.
The lawsuit claims that class members collectively faced more than $300 million in surprise costs for out-of-network health coverage after UBH failed to reimburse providers properly. The proposed class alleged that both MultiPlan and UBH violated the Employee Retirement Income Security Act (ERISA) and the Racketeer Influenced and Corrupt Organizations (RICO) Act when they engaged in the alleged scheme to underpay the claims. However, the judge expressed concerns about whether a significant number of patients have actually been damaged by the billing practices and have overpaid, and whether the U.S. medical system has numerous problems. The patients’ counsel noted ongoing antitrust litigation involving the companies and pointed out that the allegations in the instant lawsuit are narrow and only involve one specific medical code. UBH’s counsel defended the UBH’s billing practices and argued that the patients can’t show class-wide damages based on common evidence.
