Attorneys for Health Plan Participants Want $3.1 Million Award Following Settlement With UnitedHealth

UnitedHealth Tiered Reimbursement Class Action Lawsuit Overview: 

• Who: Attorneys are asking for a $3.1 million award following a $10 million settlement between UnitedHealth Group and the insurance providers’ health plan participants.
• Why: Plaintiffs claim UnitedHealth uses a tiered system to under-reimburse patients for out-of-pocket mental health care. 
• Where: The class action settlement was negotiated in New York federal court.

Attorneys representing health plan participants who agreed to a $10 million class action settlement with UnitedHealth Group have asked a New York federal court to award them $3.1 million in fees.

The award would be in addition to the overall settlement — which resolves claims UnitedHealth uses a tiered system to reimburse patients less for out-of-pocket mental health services such as talking to a psychologist or clinical social worker. 

In addition to the financial award, the settlement stipulates that UnitedHealth must stop using a tiered reimbursement system for plan participants and beneficiaries for a minimum of two years.

Attorneys told the court in a memorandum last week that they deserve the reward because of the result they helped their clients achieve.  

“Given the substantial risks plaintiffs faced in every phase of this case, the results class counsel achieved are exceptional by any measure,” the attorneys said.

The attorneys also asked the court to approve $158,662 in expenses and an award of $20,000 for three anonymous Class representatives.

Plaintiffs Jane Doe, Jane Smith, and Jane Roe claimed UnitedHealth used a tiered system to reimburse patients up to 35% less for mental health treatment than for surgical and medical procedures,

Doe, Smith, and Roe argued UnitedHealth’s reimbursement policies violated the Employee Retirement Income Security Act and the Mental Health Parity and Addiction Equity Act.

Settlement Resolves Two Class Action Lawsuits Filed Against UnitedHealth in 2017 and 2018

The settlement was the culmination of two class action lawsuits filed separately in 2017 and 2018 that were later consolidated to prepare for a settlement.

UnitedHealth has also agreed to pay $5.6 million to resolve related claims lobbied at them by New York State Attorney General Letita James and the U.S. Department of Labor. 

A class action lawsuit was filed against Horizon House last month by a former employee who alleges the mental health provider allowed the private data of thousands of patients and employees to fall into the hands of hackers. 

Were you under-reimbursed for mental health services covered by UnitedHealth Group? Let us know in the comments! 

The plaintiffs are represented by D. Brian Hufford, Jason S. Cowart, and Andrew N. Goldfarb of Zuckerman Spaeder LLP, John W. Leardi, Vincent Buttaci, and Paul D. Werner of Buttaci Leardi & Werner LLC, and Meiram Bendat of Psych-Appeal Inc.

The UnitedHealth Tiered Reimbursement Class Action Lawsuit is Doe, et al. v. UnitedHealth Group Inc. et al., Case Nos. 1:17-cv-04160 and 1:21-cv-02791, in the U.S. District Court for the Eastern District of New York.

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