Class Action Lawsuit Slams UnitedHealthcare for Denying Drug Addiction Treatment While Millions of Americans Die from the Disease
SANTA ANA, CA–On average, 130 Americans die every day from an opioid overdose.
In 2017 alone, California lost 2,196 lives to the opioid epidemic.
Drug overdoses now cause more deaths than either car accidents or guns.
There is now a critical need for access to treatment for substance use disorders. Addiction is recognized as a chronic, relapsing brain disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. Timely access to life-sustaining and life-saving treatment and continuing care for substance use and mental health disorders is critical to preventing unnecessary deaths, and allowing people to achieve long-term recovery and return to their families, friends and communities as healthy, productive and contributing members of society. Without treatment and engagement in recovery activities, addiction is progressive and can result in unemployment, homelessness, disability and premature death.
Ryan S. recognizes the necessity of timely access to treatment and continuing care for successful recovery, and he has experienced the demoralizing effect of insurance company exclusions and limitations on coverage. That is why on behalf of all persons who have suffered with substance use and mental health disorders and were denied treatment, Ryan is suing UnitedHealthcare for engaging in what he alleges to be an unlawful, institution-wide, pattern and practice of delaying, denying and underpaying claims for substance use disorder and mental health treatment despite the UnitedHealthcare plans specifically providing for benefits. The class action lawsuit in the United States District Court for the Central District of California, entitled Ryan S. v. UnitedHealth Group, Inc., et al., Case No. 8:19-cv-01363, was filed on July 11, 2019, by Ryan’s attorneys, Callahan & Blaine of Santa Ana, California.
The lawsuit describes seven company practices by UnitedHealthcare that Ryan’s lawyers allege were designed to deprive patients access to essential health care benefits in violation of a number of federal laws, including the Patient Protection and Affordable Care Act of 2010 (“PPACA”), 42 U.S.C. §§ 18001, et seq.; the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), 42 U.S.C. § 300gg-26; and the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et seq. The plaintiffs are asking the court to order UnitedHealthcare to change its practices going forward in conformity with federal law, and to remedy the effects of its past wrongful conduct.
Traditionally, the lawsuit explains, insurers have covered treatment for mental health conditions, including substance use disorders, less favorably than treatment for physical health conditions, including higher cost-sharing obligations for patients, more restrictive limits on the number of inpatient days and outpatient visits, and more onerous prior authorization requirements. That was supposed to change with passage of the MHPAEA, but has not been the case as explained by Ryan Hampton, national addiction recovery advocate, author of American Fix, and opioid addiction survivor himself.
“Parity violations aren’t the exception, they’re the rule in our country. For too long, big insurance companies – like United Healthcare – have gotten away with nothing short of murder. The name of their game is to deny basic medical care for substance use disorders at all costs – even if that cost is a human life. Over the past four years, I’ve lost over two dozen friends to preventable overdoses, people I loved and cared about. Many of them sought treatment multiple times, using their UnitedHealthcare PPO plans, only to be told their condition wasn’t medically necessary for treatment. Big insurance is playing Russian roulette with our lives. It’s time to hold them accountable. This lawsuit represents a massive step forward in raising the curtain on these deadly violations and starts to hold them accountable.”
Damon Eisenbrey of Callahan & Blaine, an expert on legal matters impacting the treatment industry, explained what’s at stake with this lawsuit. “Substance use disorder treatment is difficult and oftentimes involves cycles of recurrence and remission before long-term recovery is realized. We’re seeing insurance companies like UnitedHealthcare imposing access barriers at the patient’s initial request for treatment authorization. For those lucky and persistent enough to receive authorization, they face further exclusions and limitations on coverage that essentially deny the patient the treatment needed to recover. We intend to expose UnitedHealthcare’s objective to deny and limit coverage, in violation of industry standards and in pursuit of profits.”
Asked why he has sued the $150 billion insurance giant, Ryan S. stated, “I am alive today, clean and sober, because I was able to access the treatment I needed to fight my addiction. But I had to not only fight the demons of my addiction on my road to recovery, but also my insurance company, UnitedHealthcare. When an addict finally becomes willing to seek treatment, that window of opportunity is barely open and only for a moment. That window shouldn’t be slammed shut by insurance companies like UnitedHealthcare. I’m taking on this multi-billion dollar insurance company to tear down the barriers they’ve constructed to block patient access to treatment.”
Unfortunately for too many, there is no way to remedy the fatal effects of denied access to treatment. Jodi Barber, community advocate and Executive Producer of “Overtaken” and “Overtaken 2: Where Are They Now,” explains.
“As a mother who lost her 19-year-old son and three of his close friends in the same year, I know the importance and urgency of providing affordable, long-term treatment when someone with substance use disorder wants help. I receive calls every day from parents and from young adults desperate for help and it’s not available because of the high cost of insurance coverage or the fact that insurance won’t cover their treatment. Addiction is a brain disease and should be treated like any other disease. Deaths are occurring because of the lack of coverage.”
Leading health care attorney, Rich Collins of Callahan & Blaine, added that, “Despite the obvious public health interests, UnitedHealthcare is blatantly refusing to follow the law. And they’re doing it in the middle of an opioid epidemic! With this lawsuit, we intend to hold them responsible for their conscious disregard for the health and safety of its members like Ryan S. and for placing profits over patient care in a life and death situation.”
For more information, contact: Laurali Kobal, Firm Administrator, 714-241-4444, Laurali@callahan-law.com
ABOUT RICHARD T. COLLINS: Mr. Collins is known for being an aggressive trial attorney who has been named to the list of Super Lawyers each year since 2015. Rich has been lead counsel in over 25 jury and court trials in federal and state courts throughout California and elsewhere. He is a litigator with extensive experience in the areas of insurance recovery, coverage and bad faith, and has recovered millions of dollars for his policyholder and health care provider clients through verdicts and settlements. 714-241-4444, rcollins@callahan-law.com
ABOUT DAMON D. EISENBREY: Mr. Eisenbrey is a Senior Attorney at Callahan & Blaine. He has extensive experience in complex business litigation involving unfair methods of competition and unfair and deceptive business acts or practices, and is regarded as an expert on legal matters affecting the substance use disorder treatment industry. Mr. Eisenbrey also represents insurance policyholders and health care providers in individual and class action insurance recovery, coverage and bad faith matters, and he prosecutes and defends cases in state and federal court. 714-241-4444; deisenbrey@callahan-law.com.
ABOUT CALLAHAN & BLAINE: Founded in 1984, Callahan & Blaine is California’s Premier Litigation Firm with record-breaking verdicts and settlements in all areas of complex litigation. With a current roster of more than 28 trial lawyers experienced and focused in virtually all civil practice areas, Callahan & Blaine offers civil litigants an impressive set of credentials and client service values. Our attorneys have more than 700 years of trial experience, and since 2003, our verdicts and settlements add up to over $1.0 billion. Our law firm represents consumers and corporate, professional and entrepreneurial clients of all sizes. https://www.callahan-law.com/
Filed under: General Problems
The fix in in in New Mexico, local politicians took plenty of money from United Healthcare, enough for them to dodge taxes for 7 years. New Mexico has high rates of addiction, suicide and despair. The incestuous relationship with United Healthcare, that is a provider for their Medicare and Medicaid programs, led to more deaths, negative healthcare outcomes and more new addictions.
These huge corporations are why we need Medicare For all or Universal Healthcare. They skim at least 20% off the top of any federal and state money directed at healthcare. The CEOs are out on their yachts while people suffer and die. Our politicians refuse to analyze any of the ill effects, of these profiteers.