How UnitedHealth’s Playbook for Limiting Mental Health Coverage Puts Countless Americans’ Treatment at Risk
November 20, 2024
(ProPublica) – For years, it was a mystery: Seemingly out of the blue, therapists would feel like they’d tripped some invisible wire and become a target of UnitedHealth Group. A company representative with the Orwellian title “care advocate” would call and grill them about why they’d seen a patient twice a week or weekly for six months.
In case after case, United would refuse to cover care, leaving patients to pay out-of-pocket or go without it. The severity of their issues seemed not to matter.
Around 2016, government officials began to pry open United’s black box. They found that the nation’s largest health insurance conglomerate had been using algorithms to identify providers it determined were giving too much therapy and patients it believed were receiving too much; then, the company scrutinized their cases and cut off reimbursements. By the end of 2021, United’s algorithm program had been deemed illegal in three states. (Read More)